Wada I, Matson P L, Troup S A, Morroll D R, Hunt L, Lieberman B A
Bourn Hall Clinic, Bourn, Cambridge, UK.
Br J Obstet Gynaecol. 1993 Mar;100(3):265-9. doi: 10.1111/j.1471-0528.1993.tb15241.x.
To analyse the incidence and factors associated with the ovarian hyperstimulation syndrome (OHS) in our IVF/GIFT programme before and after the introduction of a strategy to cryopreserve all embryos from women judged to be at risk.
Two hundred forty-one consecutive IVF/GIFT cycles from January to December 1989.
Specialist fertility unit, Manchester, UK.
Pituitary suppression was effected by a daily subcutaneous injection of buserelin (500 micrograms) beginning 7 days before the expected menses. The ovarian stimulation was with variable amounts of human menopausal gonadotrophin. Ovulation was induced with 10,000 i.u. human chorionic gonadotrophin (hCG). From January to May (period A), gametes/embryos were replaced and 2000 i.u. hCG given, irrespective of the serum oestradiol (E2) concentration. From June to December (period B), all the embryos from women with an E2 > 3500 pg/ml on the day of ovulatory trigger were electively cryopreserved.
Serum E2, features of moderate or severe OHS, clinical pregnancies.
The OHS occurred in 10/105 (9.5%) and 12/136 (8.8%) cycles in periods A and B, respectively. Fewer women (6% versus 60%, P < 0.05) who had their embryos cryopreserved developed severe OHS compared with women with an E2 > 3500 pg/ml who became pregnant after gamete/embryo transfer in period A. The main factors associated with the development of OHS were serum E2 concentrations > 3500 pg/ml, whether gamete/embryos were replaced and the additional hCG given, the occurrence of a pregnancy and the presence of polycystic ovary disease.
The elective cryopreservation of all embryos from women with high E2 levels reduced the severity, but not the incidence of symptomatic OHS.
分析在采取对判定有风险女性的所有胚胎进行冷冻保存策略前后，我们体外受精/配子输卵管内移植（IVF/GIFT）项目中卵巢过度刺激综合征（OHS）的发生率及相关因素。
1989年1月至12月连续的241个IVF/GIFT周期。
英国曼彻斯特的专业生育科。
垂体抑制通过在预期月经前7天开始每日皮下注射布舍瑞林（500微克）来实现。卵巢刺激使用不同剂量的人绝经期促性腺激素。用10000国际单位人绒毛膜促性腺激素（hCG）诱导排卵。从1月至5月（A期），无论血清雌二醇（E2）浓度如何，均进行配子/胚胎移植并给予2000国际单位hCG。从6月至12月（B期），对排卵触发日E2>3500皮克/毫升女性的所有胚胎进行选择性冷冻保存。
血清E2、中度或重度OHS的特征、临床妊娠情况。
A期和B期OHS分别发生在10/105（9.5%）和12/136（8.8%）个周期中。与A期配子/胚胎移植后怀孕且E2>3500皮克/毫升的女性相比，胚胎被冷冻保存的女性发生严重OHS的较少（6%对60%，P<0.05）。与OHS发生相关的主要因素是血清E2浓度>3500皮克/毫升、是否进行配子/胚胎移植及额外给予的hCG、妊娠的发生以及多囊卵巢疾病的存在。
对E2水平高的女性的所有胚胎进行选择性冷冻保存降低了有症状OHS的严重程度，但未降低其发生率。
