Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Jianshe Dong Road, Henan, 450052, Zhengzhou, People's Republic of China.
Center for Reproductive Medicine, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Fuqiang Road, Guangdong, 518000, Shenzhen, People's Republic of China.
Reprod Biol Endocrinol. 2021 Jan 13;19(1):8. doi: 10.1186/s12958-020-00678-w.
Ovarian hyperstimulation syndrome (OHSS) is a common disease during controlled ovarian hyperstimulation treatment. However, the obstetric and neonatal outcomes of this group of patients are unknown. The aim of this study was to explore the effects of late moderate-to-critical OHSS on obstetric and neonatal outcomes.
This prospective observational study included 17,537 patients who underwent IVF/ICSI-fresh embryo transfer (ET) between June 2012 and July 2016 and met the inclusion criteria, including 7,064 eligible patients diagnosed with clinical pregnancy. Ultimately, 6,356 patients were allocated to the control group, and 385 patients who were hospitalized and treated at the center for late moderate-to-critical OHSS were allocated to the OHSS group. Then, propensity score matching analysis was performed, matching nine maternal baseline covariates and the number of multiple gestations; 385 patients with late moderate-to-critical OHSS were compared with a matched control group of 1,540 patients. The primary outcomes were the live birth rate, preterm delivery rate, miscarriage rate, gestational age at birth (weeks), obstetric complications and neonatal complications.
The duration of gestation in the matched control group was significantly higher than that in the OHSS group. The live birth delivery rate did not significantly differ between the OHSS and matched control groups. The incidence rates of the obstetric complications venous thrombosis (VT) and gestational diabetes mellitus (GDM), neonatal complications and the number of neonates admitted to the NICU were significantly higher in the OHSS group than in the matched control group.
Pregnant women undergoing IVF with fresh ET whose course is complicated by late moderate-to-critical OHSS appear to experience shortened gestation and increased obstetrical and neonatal complications compared with matched controls whose course is not complicated by OHSS. However, the live birth rate, average neonatal weight, and incidence rates of premature delivery, miscarriage, early abortion, hypertensive disorder of pregnancy (HDP), placenta previa (PP), intrahepatic cholestasis of pregnancy (ICP), and low neonatal birth weight (LBW) did not differ significantly between the two groups.
卵巢过度刺激综合征（OHSS）是控制性卵巢过度刺激治疗期间的一种常见疾病。然而，这组患者的产科和新生儿结局尚不清楚。本研究旨在探讨晚期中重度 OHSS 对产科和新生儿结局的影响。
本前瞻性观察研究纳入了 2012 年 6 月至 2016 年 7 月期间接受 IVF/ICSI-新鲜胚胎移植（ET）的 17537 名患者，并符合纳入标准，包括 7064 名符合临床妊娠诊断的患者。最终，6356 名患者被分配到对照组，385 名因晚期中重度 OHSS 住院并在中心接受治疗的患者被分配到 OHSS 组。然后，进行倾向评分匹配分析，匹配 9 个母体基线协变量和多胎妊娠数量；将 385 例晚期中重度 OHSS 患者与 1540 例匹配对照组进行比较。主要结局为活产率、早产率、流产率、出生时孕周（周）、产科并发症和新生儿并发症。
匹配对照组的妊娠持续时间明显长于 OHSS 组。OHSS 组和匹配对照组的活产分娩率无显著差异。OHSS 组静脉血栓形成（VT）和妊娠期糖尿病（GDM）、新生儿并发症和入住新生儿重症监护病房（NICU）的新生儿数量的产科并发症发生率明显高于匹配对照组。
与未发生 OHSS 的匹配对照组相比，接受新鲜 ET 的 IVF 妊娠患者在病程中发生晚期中重度 OHSS 似乎会导致妊娠时间缩短，并增加产科和新生儿并发症。然而，两组间的活产率、平均新生儿体重以及早产、流产、早期流产、妊娠高血压疾病（HDP）、前置胎盘（PP）、妊娠肝内胆汁淤积症（ICP）和低出生体重儿（LBW）的发生率均无显著差异。
