IVF-ET治疗周期中自然妊娠合并卵巢过度刺激综合征1例并文献复习

Natural pregnancy and ovarian hyperstimulation syndrome during IVF-ET cycle:a case report and literature review

目的分析体外受精-胚胎移植(IVF-ET)治疗周期中发生自然妊娠合并卵巢过度刺激综合征(OHSS)的诊疗过程。方法对1例因不孕症行控制性超促排卵(COH)发生自然妊娠合并OHSS患者的诊断过程、治疗方案和出院随访进行总结分析。结果该不孕患者因COH治疗后发生OHSS未行鲜胚移植,入院后予对症支持治疗及4次穿刺抽液治疗后,腹水仍有上升趋势,病情反复,迁延不愈。患者出院后2周检测尿妊娠试验阳性,查血人绒毛膜促性腺激素(HCG)逐渐下降,后发生生化妊娠,OHSS逐渐自愈。结论妊娠是COH治疗过程中OHSS发生的高危因素之一,可致OHSS患者病情迁延不愈,在黄体期促排卵治疗中应警惕自然妊娠发生的可能。

Objective To analyse the diagnosis and treatment process of natural pregnancy with ovarian hyperstimulation syndrome(OHSS)during in vitro fertilization and embryo transfer(IVF-ET)cycle.Methods The diagnosis process,treatment plan and discharge follow-up of a infertility patient with spontaneous pregnancy complicated with OHSS due to controlled ovarian hyperstimulation(COH)were analyzed.Results Because of OHSS after COH treatment,the infertility patient did not undergo fresh embryo transfer.After receiving symptomatic support treatment and four times of puncture and fluid extraction treatment,the volume of ascites fluid still showed an upward trend,and the condition was repeated and prolonged.Two weeks after discharge,the urine pregnancy test was positive,and the level of human chorionic gonadotropin(hCG)decreased gradually,and then biochemical pregnancy occurred.Finally,patient with OHSS was gradually recovered.Conclusion Pregnancy is one of the high risk factors of OHSS during COH treatment,which can lead to the prolonged condition in patient with OHSS.It is necessary to pay attention to the possibility of natural pregnancy in the luteal phase during ovulation induction therapy.