Author: Botros Rizk and Mohamed Aboulghar
做者：Botros Rizk and Mohamed Aboulghar
Book: Ovarian Stimulation
册本：卵巢刺激
Published by: Cambridge University Press
出书社：剑桥年夜教出书社
Editors: Botros R.M.B. Rizk
Mohamed Aboulghar
主编：Botros RMB Rizk
Mohamed Aboulghar
Ultrasound is widely used for monitoring follicular development in assisted conception. The number, size, and pattern of distribution of the follicles are important in the prediction of OHSS. Tal and co-workers found a positive correlation between the mean number of immature follicles and OHSS (1). The diagnosis of polycystic ovaries at ultrasound examination improved the prediction of OHSS to 79 percent in a Belgian multicenter study. Blankstein and colleagues stated that a decrease in the fraction of mature follicles and an increase in the fraction of very small follicles correlated with an augmented risk for the development of severe OHSS(2).
正在帮助受怨凝程中，超声波苯桡泛用于监测滤纵收育。滤纵的数目、巨细战散布形式对猜测卵巢过分刺激综开症（OHSS）十分主要。Tal及其同事发明，已成生滤纵的均匀数目取OHSS持相干干系（数据参考睹1）。正在一家比利时的多中间研讨中，超声查抄督囊卵巢的┞凤冻鹿OHSS的猜测率进步了79％。Blankstein及其同事指出，成生滤纵比例的削减战极小滤纵比例的增长，取发作严峻OHSS的风险增长相干（数据参考睹2）.
Danninger and associates studied the baseline ovarian volume prior to stimulation, to investigate whether it would be a suitable predictor for the risk of OHSS (3). They performed three-dimensional volumetric ultrasound assessment of the ovaries prior to ovarian stimulation and on the day of HCG injection. There was a significant correlation between the baseline ovarian volume and the subsequent occurrence of OHSS. The authors suggested that volumetry of the ovaries could help to detect patients at risk.
Danninger及其同事正在促欧受期开端前，对基线卵巢容量停止了研讨，去判定它能否为OHSS风险的适宜猜测参考目标（数据参考睹3）。正在卵巢刺激之前战HCG打针当天，他们对卵巢停止了三维超声波评价。基线卵巢容量取随后OHSS的发作有偏重要联系关系。做者以为，卵巢容量丈量有助于发明下危患者。
Rizk in 1993 (4) suggested a “Ten Commandments” for the prevention of OHSS. These consisted of identifying patients at risk, use of treatment of other than gonadotropins for PCOS patients- such as metformin and ovarian diathermy, and use of low doses and GnRH antagonists when gonadotropins were necessary. A second “Ten Commandments” addressed the secondary prevention of OHSS and included withholding or delaying hCG, follicular aspiration, switching to IVF with cryopreservation of all embryos, and progesterone for luteal phase support embryos, and progesterone for luteal phase support. Other measures unique to prevention of OHSS are: use of an LH or GnRH agonist in place of hCG for triggering ovulation; administration of albumin; use of glucocorticoids; and administration of dopaminergic drugs.
Rizk正在1993年（数据参考睹4）提出了防备OHSS的“十诫”。那些步伐包罗辨别有风险的患者，督囊卵巢综开症患者利用除促性腺激素之外的其他药物（如两甲单胍战卵巢透热疗法），和正在须要利用促性腺激素时利用低济鞅巴GnRH拮抗剂。第两个“十诫”触及OHSS的两级防备，包罗回绝或提早HCG的利用，滤泡抽吸，转为热冻保留一切胚胎的试管计划，徽瑰酮用于徽瑰期撑持。防备OHSS的其他共同步伐包罗：映稣瑰天生素（LH）或GnRH冲动剂替代hCG触收排卵；黑卵白给药；糖皮量激素的利用；战服用多巴胺类药物。
References 数据参考：
1. Tal J, Paz B, Samberg I, Lazarov N, Sharf M, Ultrasonographic and clinical correlates of menotropin versus sequential clomiphene citrate: menotropin therapy for induction of ovulation. Fertil Steril 1985; 44:342-349
2. Blankstein J, Shalev J, Saadon T, et al. Ovarian hyperstimulation syndrome: prediction by number and size of preovulatory ovarian follicles. Fertil Steril 1987; 47:597-602
3. Danninger B, Brunner M, Obruca A, Feichtinger W. Prediction of ovarian hyperstimulation syndrome by ultrasound volumetric assessment of baseline ovarian volume prior to stimulation. Hum Reprod 1996; 11:1597-1599
4. Rizk B. Prevention of ovarian hyperstimulation syndrome: the Ten Commandments. Presented at the 1993 European Society of Human Reproduction and Embryology Symposium, Tel Aviv, Israel, 1993: 1-2
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