Diagnosis and treatment of emergency complications after oocyte retrieval with assisted reproductive technology_West China Medical Journal

Authors：

YANG Yihong ¹ , CHEN Hanxiao ² , XU Jiawen ² ,  QIN Lang ¹

1. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education; Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

QIN Lang, Email: cacier@126.com

Keywords：

Assisted reproductive technology; Emergency complication; Ovarian hyperstimulation syndrome

DOI：

10.7507/1002-0179.201705090

Video：

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Objective To retrospectively analyze the emergency complications of the patients after oocyte retrieval with assisted reproductive technology (ART), and analyze the corresponding strategies. Methods The clinical data of patients after oocyte retrieval with ART between January and December 2016 were retrospectively anayzed. The postoperative emergency complications were observed. Results A total of 5 013 patients were included in the study. The common emergency complications after oocyte retrieval included vaginal bleeding in 137 cases (2.73%) , ovarian hyperstimulation syndrome (OHSS) in 35 (0.69%), hematuria caused by bladder injury in 11 cases (0.21%), pelvic infection in 3 (0.06%), and vagal reflex in 2 (0.04%). OHSS was related to age, the number of basal follicles, the number of oviposaccharides and the estradiol level on the day of human chorionic gonadotropin injection, but not related to the body mass index and the number of days of gonadotropin use; which might be misdiagnosed most likely. Conclusions OHSS is one of the common and severe emergency complications after oocyte retrieval with ART, which should be concerned. Active treatment of complications is helpful to reduce the incidence of emergency complications after oocyte retrieval with ART.

Citation： YANG Yihong, CHEN Hanxiao, XU Jiawen, QIN Lang. Diagnosis and treatment of emergency complications after oocyte retrieval with assisted reproductive technology. West China Medical Journal, 2017, 32(6): 828-832. doi: 10.7507/1002-0179.201705090 Copy

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3.	姜婷. 陰道超聲引導穿刺取卵術的并發癥及處理. 醫學綜述, 2014, 20(7): 1274-1277.
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6.	姜李樂, 曹國昌, 梁琳琳, 等. 卵巢過度刺激綜合征的研究現狀. 國際生殖健康計劃生育雜志, 2013(5): 391-394.
7.	Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril, 2016, 106(7): 1634-1647.
8.	龍志晶, 張秀萍, 武學清. 年齡及體質量指數對卵巢過度刺激綜合征的影響. 實用醫技雜志, 2015(4): 355-356.
9.	Lee TH, Liu CH, Huang CC, et al. Serum anti-Müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod, 2008, 23(1): 160-167.
10.	岳廷妍, 余小娟, 陳夢真, 等. 82 例中、重度卵巢過度刺激綜合征相關因素分析. 中國婦幼保健, 2016(18): 3677-3680.
11.	賈津. 分析卵巢過度刺激綜合征的相關危險因素. 實用婦科內分泌電子雜志, 2015, 2(7): 65, 67.
12.	Jayaprakasan K, Chan YE, Islam RA, et al. Prediction of in vitro fertilization outcome at different antral follicle count thresholds in a prospective cohort of 1, 012 women. Fertil Steril, 2012, 98(3): 657-663.
13.	Luke B, Brown MB, Morbeck DE, et al. Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome. Fertil Steril, 2010, 94(4): 1399-1404.
14.	馬天仲, 韋冰, 宋麗君, 等. 卵巢過度刺激綜合征的發生危險因素 Logisitic 回歸分析. 深圳中西醫結合雜志, 2016, 26(13): 1-4, 封3.
15.	Aramwit P, Pruksananonda K, Kasettratat N, et al. Risk factors for ovarian hyperstimulation syndrome in Thai patients using gonadotropins for in vitro fertilization. Am J Health Syst Pharm, 2008, 65(12): 1148-1153.
16.	Kwee J, Elting ME, Schats R, et al. Ovarian volume and antral follicle count for the prediction of low and hyper responders with in vitro fertilization. Reprod Biol Endocrinol, 2007, 5: 9.
17.	Steward RG, Lan L, Shah AA, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256, 381 in vitro fertilization cycles. Fertil Steril, 2014, 101(4): 967-973.
18.	鄭敏, 龍雯晴. 輔助生殖技術中非多囊卵巢綜合征患者發生卵巢過度刺激綜合征的高危因素分析. 診斷學理論與實踐, 2016(3): 287-290.
19.	黃家佳, 楊健之. 卵巢過度刺激綜合征危險因素及發病機制的研究進展. 生殖與避孕, 2011, 31(4): 283-287.
20.	何麗. 卵巢過度刺激綜合征的誤診分析. 中國醫學工程, 2014, 22(2): 135.

1. 于傳鑫, 李儒芝. 婦科內分泌疾病治療學. 上海: 復旦大學出版社, 2009: 2.
2. 劉風華, 楊業洲, 張松英, 等. 輔助生殖技術并發癥診斷及處理共識. 生殖與避孕, 2015, 35(7): 431-439.
3. 姜婷. 陰道超聲引導穿刺取卵術的并發癥及處理. 醫學綜述, 2014, 20(7): 1274-1277.
4. 豐有吉, 沈堅. 婦產科學. 北京: 人民衛生出版社, 2002: 413.
5. Kahnberg A, Enskog A, Br?nnstr?m M, et al. Prediction of ovarian hyperstimulation syndrome in women undergoing in vitro fertilization. Acta Obstet Gynecol Scand, 2009, 88(12): 1373-1381.
6. 姜李樂, 曹國昌, 梁琳琳, 等. 卵巢過度刺激綜合征的研究現狀. 國際生殖健康計劃生育雜志, 2013(5): 391-394.
7. Practice Committee of the American Society for Reproductive Medicine. Prevention and treatment of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertil Steril, 2016, 106(7): 1634-1647.
8. 龍志晶, 張秀萍, 武學清. 年齡及體質量指數對卵巢過度刺激綜合征的影響. 實用醫技雜志, 2015(4): 355-356.
9. Lee TH, Liu CH, Huang CC, et al. Serum anti-Müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod, 2008, 23(1): 160-167.
10. 岳廷妍, 余小娟, 陳夢真, 等. 82 例中、重度卵巢過度刺激綜合征相關因素分析. 中國婦幼保健, 2016(18): 3677-3680.
11. 賈津. 分析卵巢過度刺激綜合征的相關危險因素. 實用婦科內分泌電子雜志, 2015, 2(7): 65, 67.
12. Jayaprakasan K, Chan YE, Islam RA, et al. Prediction of in vitro fertilization outcome at different antral follicle count thresholds in a prospective cohort of 1, 012 women. Fertil Steril, 2012, 98(3): 657-663.
13. Luke B, Brown MB, Morbeck DE, et al. Factors associated with ovarian hyperstimulation syndrome (OHSS) and its effect on assisted reproductive technology (ART) treatment and outcome. Fertil Steril, 2010, 94(4): 1399-1404.
14. 馬天仲, 韋冰, 宋麗君, 等. 卵巢過度刺激綜合征的發生危險因素 Logisitic 回歸分析. 深圳中西醫結合雜志, 2016, 26(13): 1-4, 封3.
15. Aramwit P, Pruksananonda K, Kasettratat N, et al. Risk factors for ovarian hyperstimulation syndrome in Thai patients using gonadotropins for in vitro fertilization. Am J Health Syst Pharm, 2008, 65(12): 1148-1153.
16. Kwee J, Elting ME, Schats R, et al. Ovarian volume and antral follicle count for the prediction of low and hyper responders with in vitro fertilization. Reprod Biol Endocrinol, 2007, 5: 9.
17. Steward RG, Lan L, Shah AA, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256, 381 in vitro fertilization cycles. Fertil Steril, 2014, 101(4): 967-973.
18. 鄭敏, 龍雯晴. 輔助生殖技術中非多囊卵巢綜合征患者發生卵巢過度刺激綜合征的高危因素分析. 診斷學理論與實踐, 2016(3): 287-290.
19. 黃家佳, 楊健之. 卵巢過度刺激綜合征危險因素及發病機制的研究進展. 生殖與避孕, 2011, 31(4): 283-287.
20. 何麗. 卵巢過度刺激綜合征的誤診分析. 中國醫學工程, 2014, 22(2): 135.

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