Study for the etiology and therapy of polycystic ovary syndrome and ovarian hyperstimulation syndrome.

a .以脱氢表雄酮诱导的多囊卵巢综合征（PCOS）大鼠为研究对象，探讨其排卵失败的机制。PCO大鼠血清睾酮、雄烯二酮和DHEAS水平明显高于对照组。组织学研究显示，PCO大鼠卵巢出现多发囊肿。PCO大鼠卵巢基质金属蛋白酶活性低于对照大鼠。PCO大鼠卵巢赖氨酸氧化酶活性高于对照大鼠。b .我们用卵巢过度刺激综合征（OHSS）大鼠评估了血管内皮生长因子（VEGF）系统与卵巢过度刺激综合征（OHSS）的关系。与超排卵大鼠相比，OHSS大鼠血清孕酮（P4）和雌二醇（E2）显著升高。卵巢重量与超排卵大鼠相比明显增加。与超排卵大鼠相比，OHSS大鼠卵巢中VEGF的表达也有所增加。促性腺激素释放激素激动剂（GnRHa）治疗可减轻OHSS大鼠卵巢重量。GnRHa还能降低血清P4、E2和VEGF的表达。这些结果表明，VEGF表达的增加可能与OHSS有关，GnRHa治疗可能是预防OHSS的候选药物。我们研究了在注射hCG后继续使用GnRHa一周对有OHSS风险的体外受精后选择冷冻保存的患者的影响。在刚刚选择冷冻保存的患者中，5%的患者发生OHSS，需要住院治疗，因为上腹部腹水和血液浓度明显增加。然而，gnha继续治疗组没有发生OHSS。另一方面，继续使用GnRHa并没有降低卵母细胞受精率和受孕率。这是一种完全安全且成本效益高的治疗方法，对于有OHSS风险的患者应及时实施。

A.We investigated the mechanisms of ovulation failure of polycystic ovary syndrome(PCOS) using dehydroepiandrosterone-induced PCO rats. Serum testosterone, androstenedione and DHEAS levels in PCO rats were significantly higher than those in control rats. Histological study also showed multiple cysts in the ovary of PCO rats. Matirix metalloproteinase activity in ovaries of PCO rats was less than that of control rats. Lysyl oxidase activity in ovaries of PCO rats was more than that of control rats. These changes seem to inhibit breakdown of follicular wall during ovulation.B.We assessed the relationship between vascular endothelial growth factor (VEGF) system and ovarian hyperstimulation syndrome (OHSS) using OHSS rats. Serum progesterone (P4) and estradiol (E2) significantly increased in OHSS rats compared to superovulated rats. Ovarian weight significantly increased compared to superovulated rats. VEGF expression in ovaries of OHSS rats also increased compared to superovulated rats. Gonadotropin releasing hormone agonist (GnRHa) treatement reduced ovarian weight of OHSS rats. GnRHa also reduced serum P4, E2 and VEGF expression. These results propose that an increase in VEGF expression may related to OHSS and that GnRHa treatment may be a candidate for medication to prevent OHSS.C.We examined the effects of the continuation of GnRHa for a week after hCG injection on patients who were at risk for OHSS and had elective cryopreservation after in vitro fertilization. In patients who had just elective cryopreservation, 5% of patients developed OHSS necessitating hospitalization because of a marked increase in ascites in the upper abdomen and the hemoconcentration. However, none developed OHSS in GnRHa-continuation group. On the other hand, continuation of GnRHa did not reduce the rates of oocytes fertilized and pregnancy. This is a thoroughly safe and cost-beneficial treatment which should be performed promptly for patients who are at riskfor OHSS.