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甲泼尼龙预防多囊卵巢综合征患者体外受精时卵巢过度刺激综合征的随机对照试验

Methylprednisolone for prevention of ovarian hyperstimulation syndrome in patients with polycystic ovarian syndrome undergoing in-vitro fertilisation: a randomised controlled trial.

作者信息

Mohammadi Yeganeh Ladan, Moini Ashraf, Shiva Marzieh, Mirghavam Naimeh, Bagheri Lankarani Narges

机构信息

a Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center , Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran.

b Department of Gynecology and Obstetrics, Roointan Arash women's Health Research and Educational Hospital , Tehran University of Medical Sciences , Tehran , Iran.

出版信息

J Obstet Gynaecol. 2018 Feb;38(2):241-246. doi: 10.1080/01443615.2017.1346593. Epub 2017 Sep 14.

DOI:10.1080/01443615.2017.1346593
PMID:28903582
Abstract

This study aimed to evaluate the effect of methylprednisolone on prevention of ovarian hyperstimulation syndrome (OHSS) in polycystic ovarian syndrome (PCOS) patients undergoing in-vitro fertilisation (IVF). This randomised controlled trial was carried out between November 2009 and December 2013. A total of 219 eligible patients were randomly allocated for treatment (n = 108) or control groups (n = 111). The treatment group received oral methylprednisolone starting from the first day of stimulation. These patients also received an intravenous dose of methylprednisolone on the days of egg collection and embryo transfer. The control group received no glucocorticoid treatment to prevent OHSS. Nineteen percent of patients (18/93) who received methylprednisolone developed OHSS compared with 16.5% (15/91) in the control group and no significant difference was found (p = .61). There were no significant differences between treatment and control groups in the rates of implantation (10% versus 11%, p = .77) and clinical pregnancy (23.2% versus 17.7%, p = .46). Methylprednisolone did not reduce the incidence and severity of OHSS in PCOS patients undergoing IVF and no improvement in clinical outcomes was observed. Impact statement No significant differences were found in OHSS incidence and clinical outcomes between women who received methylprednisolone and control group. There seems to be no benefit for the routine use of glucocorticoids in IVF/ICSI treatments.

摘要

本研究旨在评估甲泼尼龙对接受体外受精(IVF)的多囊卵巢综合征(PCOS)患者预防卵巢过度刺激综合征(OHSS)的效果。这项随机对照试验于2009年11月至2013年12月进行。总共219名符合条件的患者被随机分配到治疗组(n = 108)或对照组(n = 111)。治疗组从刺激的第一天开始口服甲泼尼龙。这些患者在取卵和胚胎移植当天还接受静脉注射甲泼尼龙。对照组未接受预防OHSS的糖皮质激素治疗。接受甲泼尼龙治疗的患者中有19%(18/93)发生了OHSS,而对照组为16.5%(15/91),未发现显著差异(p = 0.61)。治疗组和对照组在着床率(10%对11%,p = 0.77)和临床妊娠率(23.2%对17.7%,p = 0.46)方面没有显著差异。甲泼尼龙并未降低接受IVF的PCOS患者OHSS的发生率和严重程度,也未观察到临床结局有改善。影响声明:接受甲泼尼龙治疗的女性与对照组在OHSS发生率和临床结局方面未发现显著差异。在IVF/ICSI治疗中常规使用糖皮质激素似乎没有益处。

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