Sauer M V, Paulson R J, Lobo R A
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
Int J Gynaecol Obstet. 1996 Mar;52(3):259-62. doi: 10.1016/0020-7292(95)02587-1.
To define the incidence and severity of ovarian hyperstimulation syndrome (OHSS) occurring in oocyte donors.
Women (n = 149) aged 31.3 +/- 4.8 years (mean +/- S.D., range 21-41 years) participated as designated oocyte donors and underwent 400 consecutive cycles of controlled ovarian stimulation using human menopausal gonadotropin following pituitary downregulation with gonadotropin-releasing agonist. Patients were monitored by serial transvaginal ultrasound examinations and serum estradiol (E2) determinations. Oocytes (15.6 +/- 7.5 per aspiration; range 2-57) were harvested by ultrasound-directed transvaginal follicle aspiration 36 h following the intramuscular injection of human chorionic gonadotropin (hCG). Follow-up examination occurred 1 and 2 weeks post-aspiration.
On the day of hCG injection E2 levels ranged from 512 to 13,502 pg/ml (mean 2902.7 +/- 1486.9 pg/ml). Over the next few weeks the degree of hyperstimulation in donors was staged: mild 65% (grade I, n = 98; grade II, n = 162); moderate 33.5% (grade III, n = 120; grade IV, n = 14); severe 1.5% (grade V, n = 6; grade VI, n = 0). Associated preaspiration E2 levels were: grade I, 1120 +/- 424 pg/ml; grade II, 2084 +/- 613 pg/ml; grade III, 3785 +/- 1713 pg/ml; grade IV, 5370 +/- 1264 pg/ml; grade V, 4286 +/- 1100 pg/ml. Worsening OHSS was associated with increasing levels of E2. There were no serious complications and hospitalization was not required. All symptoms resolved within 30 days of aspiration, disappearing by the time of the first menstrual flow in women of grade-III or lower stage.
Although oocyte donors commonly experienced exaggerated levels of serum E2 they rarely (< 2%) developed severe OHSS. This may be attributable to their lack of embryo transfer which avoids exacerbating the illness.
确定卵母细胞捐赠者中卵巢过度刺激综合征（OHSS）的发生率和严重程度。
149名年龄为31.3±4.8岁（平均±标准差，范围21 - 41岁）的女性作为指定卵母细胞捐赠者参与研究，在使用促性腺激素释放激动剂使垂体下调后，使用人绝经期促性腺激素进行了400个连续周期的控制性卵巢刺激。通过连续经阴道超声检查和血清雌二醇（E2）测定对患者进行监测。在肌内注射人绒毛膜促性腺激素（hCG）36小时后，通过超声引导经阴道卵泡抽吸术采集卵母细胞（每次抽吸15.6±7.5个；范围2 - 57个）。在抽吸后1周和2周进行随访检查。
在注射hCG当天，E2水平范围为512至13502 pg/ml（平均2902.7±1486.9 pg/ml）。在接下来的几周内，对捐赠者的过度刺激程度进行了分期：轻度65%（I级，n = 98；II级，n = 162）；中度33.5%（III级，n = 120；IV级，n = 14）；重度1.5%（V级，n = 6；VI级，n = 0）。抽吸前相关的E2水平为：I级，1120±424 pg/ml；II级，2084±613 pg/ml；III级，3785±1713 pg/ml；IV级，5370±1264 pg/ml；V级，4286±1100 pg/ml。OHSS病情加重与E2水平升高相关。未出现严重并发症，也无需住院治疗。所有症状在抽吸后30天内消失，III级或更低分期的女性在首次月经来潮时症状消失。
尽管卵母细胞捐赠者通常血清E2水平过高，但她们很少（<2%）发生严重OHSS。这可能归因于她们未进行胚胎移植，从而避免了病情加重。
