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目的:在体外受精-胚胎移植(IVF-ET)过程中,为预防严重卵巢过度刺激综合征(OHSS)行全胚冷冻患者的临床结局分析。方法:回顾性分析2010年1月～2011年3月在嘉兴市妇幼保健院生殖中心行辅助生殖技术的437个周期,其中为预防严重OHSS行全胚冷冻且行首次冷冻移植的90个周期为A组,同期并发OHSS行IVF-ET行新鲜周期移植的15个周期为B组,未并发OHSS的新鲜周期移植的332个周期为C组,比较3组间在控制性排卵过程中的卵泡数、获卵数、HCG日的血清雌二醇的水平,同时比较A组与C组之间的移植胚胎数、妊娠率及临床妊娠率。结果:A组患者中有2例发生了中度OHSS,B组患者中有2例为轻度OHSS,13例为中度OHSS,OHSS的发生率为3.89%;在卵泡数、获卵数及HCG日的血清雌二醇水平方面,3组比较差异均存在统计学意义(P<0.01);A组与C组的移植胚胎数、妊娠率及临床妊娠率方面差异均无统计学意义(P>0.05)。结论:IVF-ET中,OHSS发生与卵泡数、获卵数及HCG日的雌二醇呈正相关,全胚冷冻在预防严重OHSS方面有重要意义,同时并不影响临床结局。
OBJECTIVE: To analyze the clinical outcome of patients undergoing whole embryo cryopreservation in the treatment of severe ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization-embryo transfer (IVF-ET). Methods: A retrospective analysis of 437 cycles of assisted reproductive technology in the reproductive center of the MCH from January 2010 to March 2011 in which 90 cycles of A The 15 cycles of fresh cycle transplantation of OHSS concurrent IVF-ET were Group B, the 332 cycles of fresh periodic transplantation of non-concurrent OHSS were Group C, the number of follicles during controlled ovulation was compared among the three groups, The number of oocytes retrieved and the level of serum estradiol on HCG day. Meanwhile, the number of embryos transferred, the pregnancy rate and the clinical pregnancy rate between groups A and C were compared. Results: Two patients in group A had moderate OHSS, two patients in group B had mild OHSS, 13 patients had moderate OHSS, and the incidence of OHSS was 3.89%. In the number of follicles, number of oocytes retrieved and HCG day serum estradiol levels, the three groups were statistically significant differences (P <0.01); A group and C group, the number of embryos transferred, pregnancy rate and clinical pregnancy rate was no significant difference (P > 0.05). CONCLUSIONS: The incidence of OHSS in IVF-ET is positively correlated with the number of oocytes, the number of oocytes retrieved and the level of estradiol on HCG day. Whole-embryo freezing is of great significance in preventing severe OHSS without affecting the clinical outcome.