Ovarian hyperstimulation syndrome: a clinical retrospective study on 565 inpatients

Abstract

The aim of this study was to analyze clinical manifestations of 565 ovarian hyperstimulation syndrome (OHSS) inpatients in the largest Obstetrics and Gynecology hospital in China from year 2010 to 2017, to get more understanding of epidemiologic features of this disease, and to provide some insight on the diagnosis, treatment, and preventions of OHSS. It is a clinical retrospective study. In the 565 cases that developed OHSS over an eight-year period between 2010 and 2017 were reviewed, we assessed patients’ general characteristics, clinical manifestations, treatment, prognosis, and the relationship between different indicators and the severity of OHSS. Totally 12 kinds of ovulation induction protocols (Protocol 1: CC; Protocol 2: Gn; Protocol 3: hCG; Protocol 4: GnRh-a; Protocol 5: CC & Gn; Protocol 6: CC & hCG; Protocol 7: Gn & hCG; Protocol 8: GnRh-a & Gn; Protocol 9: CC & Gn & hCG; Protocol 10: GnRh-a & CC & Gn; Protocol 11: Letrozole & Gn & hCG; Protocol 12:GnRh-a & Letrozole & Gn) were analyzed and the Odds Ratio (OR) of each protocol were calculated. Five hundred and sixty-five patients were reviewed in our study. In all these patients, the number of hospitalizations, mean age, primary infertility rate, and pregnancy rate did not differ through the last 8 years. From which we may infer that the incidence rate of OHSS may not change over the last 8 years. Older patients tend to develop into more severe stage easily. The pregnancy rate was much lower in mild stage patients, but no difference was found between patients in moderate, severe and critical stage. Oocytes retrieval is strongly associated with severity. PCOS history, irregular menstrual cycle and infertility type do not seem to affect the severity of OHSS. Twelve kinds of ovulation induction protocols were analyzed, OR of different protocols were calculated, what is noteworthy is that patients who used GnRh easily developed more severe OHSS than the patients who received oocytes retrieval. We suggest that we may choose ovulation induction protocols according to the OR table while treating women with high-risk factors.

摘要

本研究旨在分析从2010年至2017年中国最大的妇产科医院565名卵巢过度刺激综合征（OHSS）住院患者的临床表现, 以进一步了解该疾病的流行病学特征, 并对OHSS的诊断、治疗和预防提供一些见解。这是一项临床回顾性研究。 我们回顾了从2010年至2017年这8年间565例发生OHSS的病例, 评估了患者的一般特征、临床表现、治疗、预后以及不同指标与OHSS严重程度之间的关系。共分析了12种诱导排卵方案（方案1：CC；方案2：Gn；方案3：hCG；方案4：GnRh-a；方案5：CC & Gn；方案6：CC & hCG；方案7：Gn & hCG；方案8：GnRh-a & Gn；方案9：CC & Gn & hCG；方案10：GnRh-a & CC& Gn；方案11：来曲唑 & Gn & hCG；方案12：GnRh-a & Letrozole & Gn）, 并计算了每种方案的比值比（OR）。在我们的研究中回顾了565名患者。在所有这些患者中, 过去8年里每年的住院次数、平均年龄、原发性不孕率和妊娠率没有变化。从中我们推断出, OHSS的发生率在过去8年中可能没有变化。年长的患者容易发展到更严重的阶段。轻度患者的妊娠率要低得多, 但中度、重度和危重患者之间没有发现差异。卵母细胞的获取与严重程度密切相关。PCOS病史、月经周期不规律和不孕类型似乎并不影响OHSS的严重程度。分析了12种诱导排卵方案, 并计算不同方案的OR, 值得注意的是, 采用GnRh的患者比接受取卵的患者更容易出现更严重的OHSS。我们建议在治疗具有高风险因素的女性时, 我们可以根据OR表选择诱导排卵方案。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• OHSS
• PCOS
• retrospective study
• ordered logit model

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

All authors have no conflict of interest to this manuscript.

Additional information

Funding

This study was supported by Natural Science Foundation from Science and Technology Commission of Shanghai Municipality [grant No. 17ZR1403100 to Xue-Lian Li] and Foundation from Shanghai Municipal Commission of Health and Family Planning [grant number 201540214 to Xue-Lian Li].