Research question

What are the risk factors affecting the incidences of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and severe hemoperitoneum in assisted reproductive technology (ART) treatment cycles?

Design

A retrospective cohort study was conducted on 1,435,108 oocyte retrieval cycles among Japanese ART registry data between 2007 and 2015. The study included 11,378 cycles with moderate-to-severe OHSS, 1182 cycles with severe hemoperitoneum, including 27 cycles with both conditions, and 1,422,575 cycles without moderate-to-severe OHSS and severe hemoperitoneum.

Results

The incidences of moderate-to-severe OHSS and severe hemoperitoneum were 0.79% and 0.08%, respectively, and decreased by 0.57-fold and 0.29-fold from 2007 to 2015, respectively. In cycles with OHSS and cycles with hemoperitoneum women were younger (odds ratios [OR] 0.91 and 0.95, respectively) and had more retrieved oocytes (OR 1.09 and 1.01, respectively) compared with cycles without both complications. The use of a gonadotrophin-releasing hormone (GnRH) agonist protocol for ovarian stimulation was the highest risk factor in cycles with OHSS and hemoperitoneum (OR 1.83 and 1.24, respectively), followed by GnRH antagonist protocol (reference), gonadotrophin with or without oral medicine (OR 0.45 and 0.56, respectively) and natural or oral medicine (OR 0.02 and 0.19, respectively). In fresh embryo transfer, clinical pregnancy was associated with an increased risk of OHSS and hemoperitoneum (OR 1.19 and 2.34, respectively).

Conclusions

The highest risk factors affecting OHSS and hemoperitoneum were the use of a GnRH agonist protocol and clinical pregnancy following fresh embryo transfer. The incidences of OHSS and hemoperitoneum have decreased yearly with a reduction of GnRH agonist use and fresh embryo transfer.

中文翻译：

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1,435,108次取卵中重度卵巢过度刺激综合征和重度腹腔积血的发生率和危险因素

研究问题

在辅助生殖技术 (ART) 治疗周期中，影响中重度卵巢过度刺激综合征 (OHSS) 和重度腹腔积血发生率的危险因素是什么？

设计

对 2007 年至 2015 年日本 ART 注册数据中的 1,435,108 个取卵周期进行了一项回顾性队列研究。该研究包括 11,378 个周期的中度至重度 OHSS、1182 个周期的重度腹腔积血，包括两种情况的 27 个周期和 1,4522 个周期无中度至重度 OHSS 和重度腹腔积血。

结果

中重度OHSS和重度腹腔积血的发生率分别为0.79%和0.08%，2007-2015年分别下降0.57倍和0.29倍。在有 OHSS 的周期和有腹腔积血的周期中，与没有这两种并发症的周期相比，女性更年轻（比值比 [OR] 分别为 0.91 和 0.95）并且获得的卵母细胞更多（OR 分别为 1.09 和 1.01）。使用促性腺激素释放激素 (GnRH) 激动剂方案进行卵巢刺激是 OHSS 和腹腔积血（OR 分别为 1.83 和 1.24）的最高风险因素，其次是 GnRH 拮抗剂方案（参考），促性腺激素有或没有口服药物（OR 分别为 0.45 和 0.56）和天然药物或口服药物（OR 分别为 0.02 和 0.19）。在新鲜胚胎移植中，

结论

影响 OHSS 和腹腔积血的最高风险因素是使用 GnRH 激动剂方案和新鲜胚胎移植后的临床妊娠。随着 GnRH 激动剂使用和新鲜胚胎移植的减少，OHSS 和腹腔积血的发生率逐年下降。