摘要
早期的自然周期体外受精-胚胎移植（IVF—ET）由于监测困难，获卵率低，加之培养室受精、卵裂、移植等技术不成熟，最终妊娠率低下。控制性促排卵（COS）治疗以期获得更多的卵子来补偿IVF过程的卵子、胚胎的丢失，提高妊娠率。
The ovarian response to Gonadotropin is a variety in controlled ovarian stimulation （COS）. High ovarian response is defined as the over-reactive to regular gonadotropin stimulation. While multiple follicles recruit and develop, the sex steroid hormones increase abnormally, which might be involved in the change of reproductive system even the functional modulation of systemic stress. Ovarian hyperstimulation syndrome （OHSS） is characterized by gross ovarian enlargement, acities, pleural effusion, hemoconcentration thrombo-embolic disorder and weight get. For COS, hCG is usually used as a trigger induce final oocyte maturation, and also a prerequisite for the OHSS. The vascular endothelial growth factor （VEGF） can identified as a vascular permeability factor. The VEGF concentrations in serum of hyper-responders were higher than that of the others. It might be the critical factor of OHSS. The high ovarian response with a narrow follicle recruitment window might be a result of an FSH receptor gene mutation. Consequently, we should start with a mild COS protocol to reduce the number of follicles and an overproduction of VEGF for preventing OHSS. Infertile patients with high risk of OHSS should be given low-dose or none hCG as trigger and luteal support. Cabergoline inhibits partially the VEGF receptor 2 phosphorylation levels and vascular permeability （VP）, reducing the early onset of OHSS. Coasting of cycles and cryopreservation of all embryos with high responders are associated with a reduced risk of OHSS. As no etiologic treatment is available, the therapeutic management of OHSS should focus on its related-complications, including intravenous calcium infusion, Amniocentesis, and protect the liver and renal function.
出处
《生殖医学杂志》
CAS
2012年第2期95-99,共5页
Journal of Reproductive Medicine
关键词
卵巢高反应
卵巢过度刺激综合征
绒毛膜促性腺激素
血管内皮生长因子
卵泡刺激素
High ovarian response
gonadotrophin Vascular endothelial growth Ovarian hyperstimulation syndrome
Human chorionic factor
Follicle stimulating hormone
