Investigation Of Chinese Medical Evidence Of Ovarian Hyperstimulation Syndrome And Analysis Of Related Factors

Objective: This study examined the TCM symptoms of patients with ovarian hyperstimulation syndrome(OHSS),in conjunction with the clinical information of the patients,in order to investigate the influencing factors relating to the severity of OHSS patients,the distribution pattern of TCM symptoms,and their association with related factors.The goal was to provide guidance for the prevention,TCM diagnosis,and treatment of OHSS.Methods: 266 patients with OHSS who underwent intracytoplasmic sperm injection(ICSI)or in vitro fertilization(IVF)for assisted conception at the Reproduction Center of the First Affiliated Hospital of USTC from January 2021 to January 2022 were chosen based on the clinical diagnostic criteria and inclusion and exclusion criteria of OHSS.The clinical conditions of the 265 OHSS patients were investigated using the epidemiological questionnaire,and the chosen patients were identified and categorized in accordance with the information of the four TCM diagnoses.The distribution characteristics of the patients’ TCM symptoms and the correlation with associated factors were then analyzed.Further research was done in order to investigate the relationship between the severity of OHSS patients and associated factors.Results:1.The 266 patients with OHSS had predominantly mild OHSS(65.0%),with moderate and severe incidence rates of 31.2% and 3.8% respectively.Age(OR=0.746,95%CI[-0.490,0.849]),BMI(OR=0.794,95%CI[0.401,0.861]),Total dose of Gn(OR=1.445,95%CI[0.087,1.648]),and number of oocytes retrieved(OR=1.177,95%CI[-0.101,1.225])were influential factors for OHSS disease severity(p<0.05),with age and BMI as protective factors;Total dose of Gn and number of oocytes retrieved as risk factors.2.Patients’ TCM patterns were,in descending order,Kidney Deficiency symptoms(9.4%)< Qi Stagnation and Dampness symptoms(15.4%)< Spleen and Kidney Yang Deficiency symptoms(21.4%)< Spleen Deficiency and Dampness symptoms(23.3%)< Blood Stasis and Water Retention symptoms(30.5%).3.There was a correlation between the distribution of patients’ TCM symptoms and age,BMI,severity of OHSS,and D-D levels on day 3 after oocyte retrieval(P<0.05),and no correlation between the distribution of patients’ TCM patterns and type of infertility,years of infertility,or cause of infertility,and WBC,HCT,PCT on day 3 after oocyte retrieval(P>0.05).4.Patients with mild OHSS were more likely to exhibit Spleen Deficiency and Dampness symptoms;Blood Stasis and Water Retention symptoms were correlated with the severity of the disease and the D-D level on day 3 following egg retrieval;those with moderate/severe OHSS and high D-D level on day 3 following egg retrieval were more likely to exhibit Blood Stasis and Water Retention symptoms;there was a correlation between Qi Stagnation and Dampness symptoms and patients’ BMI,with patients with OHSS who weighed less more likely to exhibit Qi Stagnation and Dampness symptoms;There was a correlation between Kidney Deficiency symptoms and patients’ age,with patients with OHSS aged >30 years more likely to exhibit kidney deficiency;there was no correlation between Spleen and Kidney Yang Deficiency symptoms and patients’ age,BMI and disease severity and day 3 after oocyte retrieval.Conclusion:1.Age,BMI,total Gn dose,and the number of oocytes retrieved from patients with OHSS all affect whether sick they are.Age and BMI are protective factors;Total Gn dose and number of retrieved oocytes are risk factors;the risk of severe OHSS increases with increasing total Gn dose and number of retrieved oocytes,as well as with decreasing patient age and BMI.2.Blood Stasis and Water Retention symptoms were the most frequent TCM evidence in OHSS patients,followed by Spleen Deficiency and Dampness symptoms and Spleen and Kidney Yang Deficiency symptoms.The distribution of TCM evidence in OHSS patients was related to patients’ age,BMI,severity of disease and D-D levels on day 3 after oocytes retrieved.3.Individuals with moderate to severe OHSS and high D-D levels on day 3 following oocytes retrieval are more likely to show signs of Blood Stasis and Water Retention,while patients with mild OHSS are more likely to show signs of Blood Stasis and Water Retention.OHSS patients with low body weight were more likely to have Qi Stagnation and Dampness symptoms;OHSS patients aged >30 years were more likely to have Kidney Deficiency symptoms.