Pregnancy Outcome Analysis Of Early And Late Ovarian Hyperstimulation Syndrome

Objective:Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH),may occur in early (early onset) or late (late onset). The retrospective study was designed to analyze the influence of the two types of OHSS on the pregnancy outcome and their possible clinical predictors.Methods:A total of 88 patients undergoing in vitro fertilization/ Intracytoplasmic sperm injection(IVF/ICSI) and 47 deliveried patients from January 2007 to October 2010 during the reproductive medical center in our hospital,who were hospitalized for moderate to severe OHSS were analyzied their clinical manifestations and pregnancy outcome retrospectively.Results:In 88 cycles, late OHSS occurred with severe OHSS was 6 patients (19.4%),early OHSS occurred with severe OHSS was 21 patients (30.68%).To compare the two types of data, the incidence of the type of OHSS with severe OHSS was no difference (P>0.05),but the clinical features was severe.The ratio of HCT,liver dysfunction,hydrothorax occurred with late OHSS was higher than early OHSS(35.5% VS14%; 38.7% VS5.3%; 38.7% VS8.8% respectively, P<0.05).Compared the two types of OHSS,there was no difference in their basal clinical manifestations and gonadotropin requirements. On the day of hCG administration, E2 levels of early OHSS was higher than late OHSS (4988.90±1921.45 pg/ml vs 4235.59±1077.22pg/ml, P<0.05).Women with early OHSS had collected significantly more oocytes than the late OHSS (16.89±5.81 vs 14.50±4.75, P<0.005),the difference significantly. In pregnancy loss rate, preterm birth rate,low birth weight and there was no significant difference in the two types,but related to the multiple pregnancy.Premature delivery and low birth weight of the twins were significantly higher than the single birth, 11patients(64.7%) vs 4patients(13.3 %); 13 patients(76.5%) vs 3patients(10%)respectively,P<0.05,the difference significantly.Conclusions:The late OHSS may be more severe OHSS.BMI,basal oocyte numbers and basal hormone had no relationship with the type of OHSS. The day of hCG administration, E2 levels and oocyte numbers collected may be the important clinical predictors for early OHSS. The type of OHSS was not related to obstetric outcome,but related to the multiple pregnancy.