Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome
Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome
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DOI：
10.1016/j.fertnstert.2009.05.092
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发表时间：
2010-09-01
影响因子：
6.7
通讯作者：
Stern, Judy E.
中科院分区：
文献类型：
--
作者：
Luke, Barbara;Brown, Morton B.;Stern, Judy E.
目的：评估与卵巢过度刺激综合征 (OHSS) 相关的因素及其对辅助生殖技术 (ART) 治疗和结果的影响。设计：历史队列研究。背景：基于临床的数据。患者：人群包括 2004 年至 2006 年期间进行的 214,219 个 ART 周期，并向辅助生殖技术协会临床结果报告系统在线数据库报告。研究人群仅限于无任何治疗并发症的女性 (212,041) 以及患有中度 (1,523) 或重度 (655) OHSS 的女性的自体新鲜胚胎移植周期。干预措施：无。主要结果指标：发生 OHSS 的风险因素，及其对实现妊娠和活产的影响（调整比值比）。结果：与白人女性相比，发生 OHSS 的风险为黑人女性增加（任何 OHSS，1.88；严重 OHSS，2.93），西班牙裔女性减少（任何 OHSS，0.79）。卵巢过度刺激综合征与排卵障碍（2.01）、输卵管因素（1.24）和不明原因因素（1.36）相关。卵巢过度刺激综合征增加了妊娠（任何 OHSS 为 1.98，严重为 2.68）、活产（任何 OHSS，1.86）和多胞胎活产（任何 OHSS 为 1.58，严重为 1.86）的几率。任何 OHSS 的存在都会使不良妊娠结局（死产、低出生体重或早产）的风险增加 26%，使单胎低出生体重的风险增加 40%。 结论：卵巢过度刺激综合征与妊娠和多胎妊娠的可能性较高有关，但不良妊娠结局的风险也较高。 （Fertil Steril (R) 2010；94:1399-404。(C) 2010，美国生殖医学会。）
Objective: To evaluate factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome.Design: Historic cohort study.Setting: Clinic-based data.Patient(s): The population included 214,219 ART cycles performed during 2004 to 2006 and reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System Online database. The study population was limited to cycles of autologous, fresh embryo transfers to women without any treatment complications (212,041), and those developing moderate (1,523) or severe (655) OHSS.Intervention(s): None.Main Outcome Measure(s): Risk factors for developing OHSS, and its effect on achieving a pregnancy and live birth, as adjusted odds ratios.Result(s): Compared with white women, the risk of developing OHSS was increased for Black women (any OHSS, 1.88; severe OHSS, 2.93) and decreased for Hispanic women (any OHSS, 0.79). Ovarian hyperstimulation syndrome was associated with ovulation disorders (2.01), tubal factors (1.24), and unexplained factors (1.36). Ovarian hyperstimulation syndrome increased the odds of achieving a pregnancy (1.98 with any OHSS, 2.68 with severe), a live birth (any OHSS, 1.86), and a multiple live birth (1.58 with any OHSS, 1.86 with severe). The presence of any OHSS increased the risk of an adverse pregnancy outcome (stillbirth, low birthweight, or preterm birth) by 26% and low birthweight among singletons by 40%.Conclusion(s): Ovarian hyperstimulation syndrome is associated with a higher likelihood of pregnancy, and multiple gestations, but also greater risks for adverse pregnancy outcomes. (Fertil Steril (R) 2010;94:1399-404. (C) 2010 by American Society for Reproductive Medicine.)