有OHSS病史患者诱导排卵治疗中选择FSH起始剂量的研究

Research on the starting dose of FSH during induction of ovulation among the patients with a history of OHSS

目的:研究对有OHSS病史患者采用外源性促性腺激素诱导排卵治疗中FSH起始剂量的测定方法。方法:先采用一个低剂量递增方案周期,用以确定患者有效的FSH反应剂量,第二个治疗周期改用递减方案,并把第一周期确定的有效反应剂量增加37.5IU作为起始剂量。结果:患者1在第一个低剂量递增周期中顺利排卵;患者2在第一个低剂量递增周期中因有多个优势卵泡发育而放弃该周期,但确定了其对FSH的反应剂量为187.5 IU,后以225 IU作为起始剂量,在第二个递减周期中顺利排卵。结论:有OHSS病史的患者卵巢反应特别敏感,采用低剂量递减方案之前,可以用一个低剂量递增周期确定其FSH起始剂量。超声监测数据在治疗过程中有重要的意义。

Objective：To research a method to detect the starting dose of FSH in the course of induction of ovulation with exogenous gonadotropin among the patients with a history of OHSS.Methods：A low dose step up protocol was used at first to determine the effective reaction dose of FSH,then a low dose step down protocol was used in the second cycle,the starting dose was higher than effective reaction dose in the first cycle by 37.5IU.Results：In the first cycle,the patient one ovulated successfully.The patient two gave up the first cycle because of multi-follicle development,but the reaction dose of FSH was determined at 187.5 IU,then 225IU was used as the starting dose,the patient two ovulated successfully in the second cycle.Conclusion：The ovarian reaction of patients with a history of OHSS is particularly sensitive,before adopting low dose step up protocol,a low dose step down cycle can determine the starting dose of FSH.The data of ultrasonic monitoring has important significance in the course of treatment.