Danninger B, Brunner M, Obruca A, Feichtinger W
Institute of Sterility Treatment, Vienna, Austria.
Hum Reprod. 1996 Aug;11(8):1597-9. doi: 10.1093/oxfordjournals.humrep.a019451.
The aim of the study was to find out whether the estimation of the baseline ovarian volume prior to stimulation would be a suitable predictor for the risk of ovarian hyperstimulation syndrome (OHSS). A total of 101 patients underwent in-vitro fertilization (IVF) and embryo transfer. They had a 3-D volumetric assessment of the ovaries and body weight estimations on the first day of hormonal stimulation. A second measurement was performed on the day of ovulation induction with human chorionic gonadotrophin (HCG) together with an oestradiol 17 beta estimation in serum. During the IVF programme 15 women developed OHSS and 86 did not. There was a significant correlation between the baseline ovarian volume and subsequent occurrence of OHSS (P = 0.03). Other significant relationships were found between the occurrence of OHSS and the number of follicles (P = 0.002), the number of oocytes retrieved (P = 0.0001) and the length of the cycle (P = 0.0001). The body weight before and after the stimulation was significantly lower in the group of women who did develop the syndrome (P = 0.011 resp. 0.03). The oestradiol 17 beta concentration on the day of HCG administration in the serum of the patients who had OHSS was significantly higher (P = 0.0001). In conclusion, volumetry of the ovaries could help to detect patients at risk and prevent the occurrence of OHSS by early adjustment of the hormonal dosage. Recent advances in ultrasound technology (3-D ultrasound) enable quick and highly accurate volumetric assessments. Furthermore, our study confirms previous observations that low body weight and long cycles seem to be additional risk factors for the development of OHSS.
本研究的目的是确定在刺激前对基线卵巢体积的评估是否可作为卵巢过度刺激综合征（OHSS）风险的合适预测指标。共有101例患者接受了体外受精（IVF）和胚胎移植。在激素刺激的第一天，对她们的卵巢进行了三维体积评估并测量了体重。在使用人绒毛膜促性腺激素（HCG）进行排卵诱导当天进行了第二次测量，并同时测定了血清中的雌二醇17β水平。在IVF治疗过程中，15名女性发生了OHSS，86名未发生。基线卵巢体积与随后OHSS的发生之间存在显著相关性（P = 0.03）。还发现OHSS的发生与卵泡数量（P = 0.002）、回收的卵母细胞数量（P = 0.0001）和周期长度（P = 0.0001）之间存在其他显著关系。发生该综合征的女性组刺激前后的体重显著降低（分别为P = 0.011和0.03）。发生OHSS的患者血清中HCG给药当天的雌二醇17β浓度显著更高（P = 0.0001）。总之，卵巢体积测量有助于发现有风险的患者，并通过早期调整激素剂量预防OHSS的发生。超声技术（三维超声）的最新进展能够实现快速且高度准确的体积评估。此外，我们的研究证实了先前的观察结果，即低体重和长周期似乎是OHSS发生的额外风险因素。
