在高反应人群中如何预防卵巢过度刺激综合征

How to prevent OHSS in patients with high ovarian response?

卵巢过度刺激综合征(OHSS)是一种严重的、可能危及生命的综合征,为辅助生殖技术的主要并发症之一,是卵巢对外源性促性腺激素过度反应的后果。卵巢高反应显著增加OHSS风险及IVF周期取消率。目前OHSS尚缺乏针对性强的治疗方法,预防远比治疗更重要。对于卵巢高反应人群,早期鉴别潜在风险因素,进行积极的临床预防干预,可显著降低OHSS的发生。OHSS预防主要包括IVF方案调整及药物预防两方面。目前具有良好循证学证据支持的OHSS预防策略包括:使用GnRH拮抗剂方案,使用GnRH激动剂扳机,全胚冷冻;以及给予阿司匹林、多巴胺激动剂、二甲双胍等进行药物预防。

Ovarian hyperstimulation syndrome（OHSS）is a serious life-threatening complication associated with controlled ovarian stimulation during assisted reproductive technology（ART）.Hyperresponse to gonadotrophin stimulation could possibly lead to an increase in OHSS incidence and cycle cancellation.There is currently a lack of targeted treatment for OHSS.Therefore prevention of OHSS is more important than treatment.Early recognition of risk factors for OHSS can help clinicians to adjust prevention regimens to reduce the risk of OHSS.OHSS prevention strategies include the adjustment of ovarian stimulation protocol and medication prevention.There is good evidence to support administration of GnRH antagonist protocol and using GnRH agonist to trigger oocyte maturation in women at high risk of OHSS.Additional strategies to prevent OHSS include administration of dopamine agonist,aspirin and metformin,as well as cryopreservation of whole embryos.