Department of Gynecology, OB/GYN Hospital, Fudan University, Shanghai, China.
Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China.
Gynecol Endocrinol. 2020 Apr;36(4):313-317. doi: 10.1080/09513590.2019.1653275. Epub 2019 Aug 20.
The aim of this study was to analyze clinical manifestations of 565 ovarian hyperstimulation syndrome (OHSS) inpatients in the largest Obstetrics and Gynecology hospital in China from year 2010 to 2017, to get more understanding of epidemiologic features of this disease, and to provide some insight on the diagnosis, treatment, and preventions of OHSS. It is a clinical retrospective study. In the 565 cases that developed OHSS over an eight-year period between 2010 and 2017 were reviewed, we assessed patients' general characteristics, clinical manifestations, treatment, prognosis, and the relationship between different indicators and the severity of OHSS. Totally 12 kinds of ovulation induction protocols (Protocol 1: CC; Protocol 2: Gn; Protocol 3: hCG; Protocol 4: GnRh-a; Protocol 5: CC & Gn; Protocol 6: CC & hCG; Protocol 7: Gn & hCG; Protocol 8: GnRh-a & Gn; Protocol 9: CC & Gn & hCG; Protocol 10: GnRh-a & CC & Gn; Protocol 11: Letrozole & Gn & hCG; Protocol 12:GnRh-a & Letrozole & Gn) were analyzed and the Odds Ratio (OR) of each protocol were calculated. Five hundred and sixty-five patients were reviewed in our study. In all these patients, the number of hospitalizations, mean age, primary infertility rate, and pregnancy rate did not differ through the last 8 years. From which we may infer that the incidence rate of OHSS may not change over the last 8 years. Older patients tend to develop into more severe stage easily. The pregnancy rate was much lower in mild stage patients, but no difference was found between patients in moderate, severe and critical stage. Oocytes retrieval is strongly associated with severity. PCOS history, irregular menstrual cycle and infertility type do not seem to affect the severity of OHSS. Twelve kinds of ovulation induction protocols were analyzed, OR of different protocols were calculated, what is noteworthy is that patients who used GnRh easily developed more severe OHSS than the patients who received oocytes retrieval. We suggest that we may choose ovulation induction protocols according to the OR table while treating women with high-risk factors.
本研究旨在分析 2010 年至 2017 年中国最大的妇产科医院 565 例卵巢过度刺激综合征（OHSS）住院患者的临床表现，以更深入了解该疾病的流行病学特征，并为 OHSS 的诊断、治疗和预防提供一些见解。这是一项临床回顾性研究。在 2010 年至 2017 年的 8 年期间，对 565 例发生 OHSS 的患者进行了回顾性评估，我们评估了患者的一般特征、临床表现、治疗、预后以及不同指标与 OHSS 严重程度的关系。共分析了 12 种排卵诱导方案（方案 1：CC；方案 2：Gn；方案 3：hCG；方案 4：GnRh-a；方案 5：CC+Gn；方案 6：CC+hCG；方案 7：Gn+hCG；方案 8：GnRh-a+Gn；方案 9：CC+Gn+hCG；方案 10：GnRh-a+CC+Gn；方案 11：来曲唑+Gn+hCG；方案 12：GnRh-a+来曲唑+Gn），并计算了每种方案的优势比（OR）。本研究共回顾了 565 例患者。在所有这些患者中，过去 8 年中，住院次数、平均年龄、原发性不孕率和妊娠率没有差异。从中我们可以推断，过去 8 年中 OHSS 的发病率可能没有变化。年龄较大的患者往往更容易发展为更严重的阶段。轻度患者的妊娠率较低，但中度、重度和极重度患者之间没有差异。取卵与严重程度密切相关。PCOS 病史、月经周期不规则和不孕类型似乎并不影响 OHSS 的严重程度。分析了 12 种排卵诱导方案，计算了不同方案的 OR，值得注意的是，接受 GnRh 治疗的患者比接受取卵的患者更容易发生更严重的 OHSS。我们建议，在治疗有高危因素的女性时，我们可以根据 OR 表选择排卵诱导方案。
