多囊卵巢综合征(PCOS)患者在IVF-ET中发生严重卵巢过度刺激综合征(OHSS)的特点分析

目的:通过总结IVF-ET中多囊卵巢综合征(PCOS)患者应用控制性超促排卵(COH)后发生卵巢过度刺激综合征(OHSS)的特点,提出防止中、重度OHSS发生的有效措施。方法:将IVF/ICSI治疗时出现中、重度OHSS的患者根据有无PCOS史分成PCOS组和对照组。比较分析PCOS组和非PCOS组在COH中的雌激素水平、卵泡数、取卵数及发生中、重度OHSS的时间等临床资料;分析妊娠对OHSS的影响。结果:PCOS组的Gn用药总量及hCG注射日的血清E2水平比对照组低,其总卵泡数、中小卵泡数明显高于对照组,发生中、重度OHSS的时间早,妊娠可能加重OHSS病情发展。结论:卵泡总数、中小卵泡数可作为PCOS患者预测中、重度OHSS独立的重要指标,建议即使取卵前E2水平不高、获卵数不多也考虑行全胚冷冻,以阻止严重的OHSS发生。

Analysis of Serious OHSS in PCOS Patients during IVF-ET

Objective: To retrospectively analyze the characteristics of ovarian hyperstimulation syndrome(OHSS) in polycystic ovarian syndrome(PCOS) patients undergoing hormonal stimulation during IVF/ICSI in order to provide measurement to prevent serious OHSS.Methods: The patients with medium and serious OHSS undergoing IVF/ICSI were collected and divided into PCOS group and the control.Serum E2,follicular number,oocyte number,OHSS time,and the effect of pregnancy on OHSS were compared between the two groups.Results: The total dosage of Gn used and serum E2 level on hCG injection day were lower in PCOS group than in the control,and the follicle number was higher in PCOS group than in the control,the OHSS occurred much earlier in PCOS group and pregnancy can aggravate it.Conclusion: The follicle number,medium and small follicle number can prognose medium and serious OHSS in PCOS patients,suggesting that even no high E2 level and high oocyte number,freezing all embryos may be still associated with the prevention of serious OHSS.