Barrière P, Dewailly D, Duhamel A, Gayet V
CHU de Nantes, 44093 Nantes, France.
Gynécologie endocrinologie et médecine de la reproduction, hôpital Jeanne-de-Flandre, Lille university hospital, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
Gynecol Obstet Fertil Senol. 2017 May;45(5):283-290. doi: 10.1016/j.gofs.2017.03.004. Epub 2017 Apr 29.
Data on the incidence and severity of ovarian hyperstimulation syndrome (OHSS) in France are limited.
Prospective observational multicentric study (23 French centers of IVF) in a cohort of 421 women treated with highly purified hMG (HP-hMG) for the first or second cycle of IVF with or without ICSI. The primary objective was to assess the incidence of moderate to severe OHSS in this cohort.
At inclusion, 172 patients (40.9%) were considered at risk of OHSS by the physicians. The main measures for risk minimization taken by the physicians rested on initial dose of HP-hMG and protocol choice. At the end of the follow-up (4 months in average), the rate of OHSS moderate to severe was 2.4% (confidence interval 95%: 1.1-4.3%) for the studied IVF cycle. OHSS was severe for 3 women (0.7%) and moderate for 7 women (1.7%).
This rate of OHSS after IVF is at the lower limit of the rates reported in the literature for OHSS. This study brings reassuring epidemiological data on the rate of OHSS in women at risk. The measures taken by the physicians to minimize the risk of OHSS could have contributed to this low incidence.
法国关于卵巢过度刺激综合征（OHSS）发病率和严重程度的数据有限。
在一项前瞻性观察性多中心研究（23个法国试管婴儿中心）中，对421名接受高纯度人绝经期促性腺激素（HP-hMG）治疗的女性进行研究，她们处于试管婴儿的第一个或第二个周期，采用或不采用卵胞浆内单精子注射（ICSI）技术。主要目的是评估该队列中中度至重度OHSS的发病率。
纳入研究时，医生认为172名患者（40.9%）有发生OHSS的风险。医生采取的主要降低风险措施取决于HP-hMG的初始剂量和方案选择。随访结束时（平均4个月），在所研究的试管婴儿周期中，中度至重度OHSS的发生率为2.4%（95%置信区间：1.1 - 4.3%）。3名女性（0.7%）发生重度OHSS，7名女性（1.7%）发生中度OHSS。
试管婴儿后OHSS的这一发生率处于文献报道的OHSS发生率下限。本研究提供了关于有风险女性OHSS发生率的可靠流行病学数据。医生采取的降低OHSS风险的措施可能导致了这一低发病率。
