A Second Dose of GnRHa in Combination with Luteal GnRH Antagonist May Eliminate Ovarian Hyperstimulation Syndrome in Women with≥30 Follicles Measuring≥11 mm in Diameter on Trigger Day and/or Pre-trigger Peak Estradiol Exceeding 10 000 pg/mL  

作　　者：Ling DENG Xue-Ian LI De-sheng YE Christophe Blockeel Xing-yu ZHOU Shi-ling CHEN Xin CHEN 

机构地区：[1]Center for Reproductive Medicine,Department of Gynecology and Obstetrics,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China [2]Department of Reproductive Medicine,Jiangmen Central Hospital,Jiangmen 529030,China [3]Centre for Reproductive Medicine,Universitair Ziekenhuis Brussel(UZ Brussel),Laarbeeklaan 101-1090 Brussels,Belgium

出　　处：《Current Medical Science》2019年第2期278-284,共7页当代医学科学（英文）

基　　金：the National Natural Science Foundation of China(No.81401177);Guangdong Province Natural Science Foundation(No.2015A030313286);Milstein Medical Asian American Partnership Foundation Fellowship Award in Reproductive Medicine,Nanfang Hospital High-level Project Matching Funds(No.G2014005).

摘　　要：This observational study included 21 patients at remarkably high risk of ovarian hyperstimulation syndrome(OHSS),characterized by more than 30 follicles measuring≥11 mm in diameter on trigger day and/or pre-trigger peak estradiol exceeding 10 000 pg/mL.which was also the feature of women with established severe early OHSS followed by gonadotrophin-releasing hormone agonist(GnRHa)trigger and freeze-all policy that previously have been reported.All patients received a second dose of GnRHa 12 h after the first GnRHa trigger combined with administration of GnRH antagonist at 0.25 mg/day for a period of 3 days from the day of oocyte retrieval onwards.The in vitro fertilization(IVF)outcomes may be preferable compared with a bolus of GnRHa trigger and none of the included patients developed moderate-to-severe OHSS.Moreover,patients'symptoms,reproductive honnone levels and ultrasound findings were improved significantly.This new strategy seems to be efficacious and could be a further supplement of GnRHa trigger with or without applying freeze-all strategy to completely prevent early-onset moderate to severe OHSS,especially for the patients characterized by≥30 follicles measuring≥11 mm in diameter on trigger day and/or pre-trigger peak estradiol exceeding 10 000 pg/mL.Further studies should be performed to compare this regimen with conventional methods of OHSS prevention.

关 键 词：in-vitro fertilization ovarian HYPERSTIMULATION syndrome GNRH AGONIST GNRH ANTAGONIST freeze-all 

分 类 号：R737.33[医药卫生—肿瘤]