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目的:比较体外受精-胚胎移植/卵母细胞胞浆内单精子注射(IVF-ET/ICSI)患者中发生中重度卵巢过度刺激综合征(OHSS)患者与非OHSS患者相关指标,筛选预测指标,指导临床医生预防OHSS的发生。方法:回顾分析IVF-ET/ICSI患者共300个病例周期,包括中重度OHSS组(33例)和非OHSS组(267例)。结果:OHSS组患者年龄轻,基础窦卵泡(AFC)多,促性腺激素(Gn)总量低,注射绒毛膜促性腺激素(HCG)日卵泡总数多,血雌二醇(E2)水平高,孕酮(P)水平高,获卵数和MII卵子数多,两组比较差异具有统计学意义(P<0.05)。Logisitic单因素回归分析结果显示:年龄和使用Gn总量为保护因素,而AFC,注射HCG日卵泡总数,血E2水平和P水平,获卵数和MII卵子数为危险因素。但是多因素Logisitic回归分析结果显示:注射HCG日卵泡总数是唯一能预测OHSS发生的指标。结论:注射HCG日卵泡总数是预测中重度OHSS发生的有效指标。
OBJECTIVE: To compare the related indexes of patients with moderate-severe ovarian hyperstimulation syndrome (OHSS) and non-OHSS patients with in vitro fertilization-embryo transfer / intracytoplasmic sperm injection (IVF-ET / ICSI) Guide clinicians to prevent the occurrence of OHSS. METHODS: A total of 300 case-cycles of IVF-ET / ICSI were retrospectively analyzed, including moderate-severe OHSS (33 cases) and non-OHSS (267 cases). Results: The patients in OHSS group were younger, had more AFC, lower total gonadotropin (Gn), had more total follicles injected with human chorionic gonadotropin (HCG) and had higher estradiol (E2) The level of progesterone (P), the number of oocytes retrieved and the number of MII oocytes were significantly different between the two groups (P <0.05). Logistic regression analysis showed that the age and the total amount of Gn used as protective factors, while AFC, the total follicles injected HCG, blood E2 and P levels, the number of oocytes retrieved and the number of MII eggs were risk factors. However, multivariate Logisitic regression analysis showed that the total number of follicles injected on HCG day was the only predictor of OHSS. Conclusion: The total number of follicles injected with HCG is a valid predictor of the occurrence of moderate-severe OHSS.