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冻融胚胎移植妊娠中卵巢过度刺激综合征:一例罕见病例报告。

Ovarian hyperstimulation syndrome in a frozen-thawed embryo transfer pregnancy: a rare case report.

机构信息

Department of Reproductive Medicine, Jinhua People's Hospital, Jinhua, 321000, Zhejiang, China.

出版信息

BMC Pregnancy Childbirth. 2020 May 20;20(1):313. doi: 10.1186/s12884-020-03014-7.

Abstract

BACKGROUND

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovarian stimulation. Prevention and early recognition of OHSS are important to ensure patient safety.

CASE PRESENTATION

In this case, we reported a patient who underwent controlled ovarian hyperstimulation (COH) and in vitro fertilization (IVF). All embryos were cryopreserved to reduce possible OHSS. However, OHSS still occurred after the patient had a frozen-thawed embryo transfer (FET) with hormone replacement therapy (HRT) and obtained a dichorionic diamniotic triplet pregnancy. After multifetal pregnancy reduction (MFPR) and supportive treatment, all the symptoms regressed.

CONCLUSIONS

Prompt recognition of OHSS, especially in patients who have no history of ovulation induction and fresh embryo transfer, is very important. Multiple pregnancies may lead to severe OHSS because of the high level of human chorionic gonadotropin (hCG) in the early stages. We suggest that a single embryo transfer may be necessary and beneficial for patients.

摘要

背景

卵巢过度刺激综合征(OHSS)是卵巢刺激的一种医源性并发症。预防和早期识别 OHSS 对于确保患者安全非常重要。

病例介绍

在本例中,我们报告了一位接受控制性卵巢过度刺激(COH)和体外受精(IVF)的患者。为了降低可能发生的 OHSS 的风险,所有胚胎均被冷冻保存。然而,在患者接受激素替代疗法(HRT)的冻融胚胎移植(FET)并获得双绒毛膜双羊膜三胎妊娠后,仍发生了 OHSS。经过多胎妊娠减胎(MFPR)和支持治疗后,所有症状均消退。

结论

及时识别 OHSS 非常重要,特别是对于没有排卵诱导和新鲜胚胎移植史的患者。由于 hCG 水平在早期较高,多胎妊娠可能导致严重的 OHSS。我们建议对于患者来说,单胚胎移植可能是必要且有益的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12b8/7238628/41fcaa33a1cc/12884_2020_3014_Fig1_HTML.jpg

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