卵母细胞体外成熟预防卵巢过度刺激综合征的应用

Application of oocytes in vitro maturation in preventing ovarian hyperstimulation syndrome.Jin Rentao

目的:探讨卵母细胞体外成熟预防卵巢过度刺激综合征(ovarian hyperstim- ulation syndrome,OHSS)的效果。方法:51例IVF长方案超排卵过程中出现OHSS早期征象时,按患者意愿分成两组,实验组于当天注射人绒毛膜促性腺激素(hCG)36h后取卵,经体外培养成熟行体外受精、胚胎移植;对照组则继续按常规用药方案及受精方案行胚胎移植。测定两组出现OHSS早期征象当日的E_2、统计FSH用药天数、用药量、受精率及临床妊娠率。结果:实验组与对照组在出现OHSS早期征象当日的血E_2水平、受精率、优质胚胎率、临床妊娠率无统计学差异;但实验组的FSH总用量、FSH用药天数、获卵数方面显著低于对照组(P<0.05)。实验组1例发生中度OHSS,对照组则发生3例重度OHSS和2例中度OHSS,重度OHSS发生率差异极显著(P<0.01)。结论:超排卵过程中,出现OHSS早期征象时改行卵母细胞体外成熟培养技术可有效地降低OHSS的发生率。

Objective：To explore the effectiveness of oocytes in vitro maturation in preventing ovarian hyperstimulation syndrome. Methods：The routine IVF/ICSI long protocol were given to 51 infertile patients when there were early signs of occurrence of OHSS, the patients were divided into two groups according to their own selection. HCG was administered on that day in experimental group, then the follicle was aspirted and maturated in vitro after 36hour. The control group continued routine protocol. Clinical parameters including estradiol levels on the day of early signs of occurrence of OHSS, the total days of stimulation and dosages were monitored. In addition, the rate of fertilization and clinical pregnancy （CPR） were recorded. Results ：There were no significant differerce in estradiol levels, the fertilization rate, the good embryo rate and CPR between the experimental and control groups. While the dosages of Gn, the days of stimulation, the number of acquired oocyte in experimental group was much less than that in control group （P 〈 0.05 ）. No severe except one moderate OHSS occurred in experiment group,whereas there had three severe and two moderate OHSS in control group（P 〈0.01 ,P 〈 0.05）. Conclusion：Follicle araspiration associated with maturation in vitro can reduce OHSS incidence in high risk patients undergoing IVF-ET without jeopardizing the pregnancy outcome.