Maternal-fetal outcomes in patients with severe ovarian hyperstimulation syndrome after fresh embryo transfer
10.3760/cma.j.cn101441-20201111-00613
- VernacularTitle:新鲜胚胎移植术后并发重度卵巢过度刺激综合征患者的母婴结局分析
- Author:
Li CHEN
1
;
Lijuan HAO
1
;
Yan SHI
1
;
Yingzheng PAN
1
Author Information
1. 重庆市妇幼保健院/重庆医科大学附属妇女儿童医院妇产科，重庆 401147
- Publication Type:Journal Article
- Keywords:
Ovarian hyperstimulation syndrome;
Embryo transfer,fresh;
Pregnancy outcome;
Maternal and neonatal outcome
- From:
Chinese Journal of Reproduction and Contraception
2022;42(7):666-674
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of severe ovarian hyperstimulation syndrome (OHSS) after fresh embryo transfer on the maternal and neonatal outcomes of patients.Methods:A respective cohort study was performed. Totally 155 patients with severe OHSS (OHSS group) treated in the Department of Obstetrics and Gynecology of Chongqing Health Center for Women and Children and received fresh embryo transfer in the Reproductive Center from January 2018 to December 2018 were selected, and 366 clinical pregnant patients without OHSS after transplantation served as control group (non-OHSS group). According to Mathur's OHSS time classification standard, OHSS patients were divided into early-onset subgroup, occurring within 9 d (including 9 d) after oocytes retrieved, and late-onset subgroup, occurring within 10 d or more after oocytes retrieved; according to the number of pregnancies, patients were divided into singleton subgroup and twin subgroup. The differences in maternal and neonatal outcomes (primary indicators) and clinical indicators (secondary indicators) were compared between the two groups.Results:In OHSS group, 34 early-onset and 121 late-onset, 80 singletons and 75 twins were included and in non-OHSS group 194 singletons and 172 twins were included. Compared with non-OHSS group, patients in OHSS group had lower maternal age [(29.99±4.02) years vs. (31.85±3.62) years, P<0.001] and bigger number of oocytes retrieved (11.62±4.17 vs. 9.48±4.39, P<0.001). For OHSS patients, compared with late-onset group, the ovarian size [(7.95±1.46) cm vs. (7.26±1.41) cm], depth of chest water [(5.83±4.57) cm vs. (3.69±4.20) cm], hematocrit (HCT) [(44.59±4.85)% vs. (42.03±4.53)%], D-dimer [(2.87±1.84) mg/L FEU vs. (2.01±1.09) mg/L FEU], percentage of patients undergoing abdominal puncture and hospitalization days [(12.91±6.64) d vs. (10.12±6.18) d] were higher in early-onset group ( P=0.013, P=0.012, P=0.005, P<0.001, P=0.023, P=0.024), while the number of oocytes retrieved, serum albumin (ALB), level of liver enzyme and percentage of patients undergoing pleural puncture were not significantly different between the two groups (all P>0.05). The clinical data had no significant differences between singleton subgroup and twin subgroup (all P>0.05). The twins rate, the miscarriage rate, the ectopic pregnancy rate and the live birth rate were not significantly different between OHSS group and non-OHSS group (all P>0.05). There were no statistically significant differences in twin rate, live birth rate, obstetric complications, cesarean section rate, postpartum hemorrhage rate or neonatal outcomes between the early and late OHSS patients (all P>0.05). Whether in singleton pregnancy or twin pregnancy, the obstetric complications, preterm birth rate, postpartum bleeding rate and neonatal outcome were not significantly different between OHSS group and non-OHSS group (all P>0.05). Whether in OHSS or non-OHSS patients, the preterm birth rate [54.46% (116/213)], the cesarean section rate [96.71% (206/213)] and the low birth weight rate [59.39% (253/426)] were higher in twin subgroup than in singleton subgroup [11.60% (29/250), P<0.001; 74.00% (185/250), P<0.001; 5.20% (13/250), P<0.001]. Conclusion:The presentation and onset time of severe OHSS after fresh embryo transplantation had no adverse effect on the long-term pregnancy complications and pregnancy outcomes. Early-onset severe OHSS increased adverse effects on maternal in early pregnancy. Multiple pregnancies significantly increase the neonatal adverse outcomes.
