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体外受精中卵巢过度刺激综合征(OHSS)的风险因素及预测方法。

Risk Factors and Methods for Predicting Ovarian Hyperstimulation Syndrome (OHSS) in the in vitro Fertilization.

机构信息

Belgorod State University, 85 Pobedy St., Belgorod, 308015, Russia.

Belgorod Regional Hospital, 8 Nekrasova St., Belgorod, 308009, Russia.

出版信息

Arch Razi Inst. 2021 Nov 30;76(5):1461-1468. doi: 10.22092/ari.2021.355581.1700. eCollection 2021 Nov.

Abstract

Ovarian hyperstimulation syndrome (OHSS) is the most severe and life-threatening complication of assisted reproductive technologies (ART). OHSS is based on an excessive ovarian response to ovarian stimulation; however, the pathogenesis has not been fully understood yet. The most serious complications of OHSS are thromboembolic complications and ovarian torsion. The current study describes the risk factors for the development of ovarian hyperstimulation syndrome and proposes a method for specific prediction of this syndrome. This study was designed to investigate 671 therapeutic cycles in the IVF program during 2009-2018. All patients were divided into two groups. Group one (n=56) included women who developed OHSS during the IVF procedure. Group two (n=615) consisted of women who did not have this complication during the IVF procedure. All the observation and examination outcomes were entered into a specially developed questionnaire, and then into a Microsoft Excel spreadsheet. The data were processed by variable statistics using Statistica 10.0. Analyzing of the recorded data revealed that the rate of OHSS was higher in the group of younger women, aged 30.76±3.67 years, in comparison with those aged 32.78±4.40 years in the group of patients without OHSS (<0.05). The analysis of the initial phase of the reproductive system has confirmed that the group of patients with OHSS had a higher level of prolactin, 462.84±191.56 mIU/L in comparison with 363.43±187.84 mIU/L, which corresponded to the group of women without OHSS (p<0.05). In our results, 7.15±1.04% of cases with OHSS had obesity, while of the patients from the group without OHSS suffered from it (<0.05). OHSS is the most severe iatrogenic complication of ART, therefore it is extremely important to consider its risk factors and take timely preventive measures. This study has established a high relationship between the studied risk factors and ovarian hyperstimulation syndrome and proposed a model for predicting this syndrome.

摘要

卵巢过度刺激综合征(OHSS)是辅助生殖技术(ART)最严重和危及生命的并发症。OHSS 是基于卵巢对卵巢刺激的过度反应;然而,其发病机制尚未完全了解。OHSS 最严重的并发症是血栓栓塞并发症和卵巢扭转。目前的研究描述了卵巢过度刺激综合征发展的危险因素,并提出了一种预测该综合征的具体方法。本研究旨在调查 2009-2018 年期间 IVF 计划中的 671 个治疗周期。所有患者分为两组。一组(n=56)包括在 IVF 过程中发生 OHSS 的女性。二组(n=615)由在 IVF 过程中没有发生这种并发症的女性组成。所有观察和检查结果均输入专门开发的问卷,然后输入 Microsoft Excel 电子表格。数据通过变量统计使用 Statistica 10.0 进行处理。对记录数据的分析表明,在 30.76±3.67 岁的年轻女性组中,OHSS 的发生率高于无 OHSS 的 32.78±4.40 岁组(<0.05)。对生殖系统初始阶段的分析证实,OHSS 组的催乳素水平较高,为 462.84±191.56 mIU/L,而无 OHSS 组的催乳素水平为 363.43±187.84 mIU/L(p<0.05)。在我们的结果中,7.15±1.04%的 OHSS 患者肥胖,而无 OHSS 的患者肥胖(<0.05)。OHSS 是 ART 最严重的医源性并发症,因此考虑其危险因素并及时采取预防措施极为重要。本研究确立了所研究的危险因素与卵巢过度刺激综合征之间的高度关系,并提出了预测该综合征的模型。

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