A Retrospective Analysis Of Abnormal Lipid Metabolism And Ovarian Hyperstimlation Syndrome

Background:Ovarian hyperstimulation syndrome(OHSS)is one of common and complex complications after human assisted technology(ART)and mainly occurs in the process of controlled ovarian hyperstimulation.Nowadays,the pathological mechanism of OHSS is unclear.Overall related literatures lately,the main event in pathogenesis of OHSS is an increase in the permeability of capillaries,while fluid leakage into the third lacuna,causes systematic hemodynamic change.The major clinical manifestations including increase of ovarian volume,abdominal pain,ascites,pleural effusion,oliguria and electrolyte disorder.Mainly risk factors inducing OHSS involves young age,low weight,high level of anti-Mullerian hormone(AMH),high peak level of estradiol(E2),multiple follicular development,high number of retrieved oocytes,pregnancy,etc.The damage to vascular wall caused by abnormal lipid metabolism has been proved by recent research,which increase the permeability of capillaries.It is rare to report the correlation between OHSS and lipid metabolism and need further research to explore whether there is connection between them.Objective:To evaluate the effect of abnormal lipid metabolism on the incidence of moderate and severe Ovarian hyperstimulation syndrome(OHSS)in the duration of assisted reproduction techniques(ART),to compare the differences in the number of oocytes and total dose gonadotrophin between patients with abnormal lipid metabolism and ones free from lipid metabolism disorder,aimed to provide theoretical basis for prevention,clinical treatment of OHSS and choose of assisted reproductive strategy for women with abnormal lipid metabolismMethods:A retrospective analysis of 233 patients with moderate or severe OHSS who received treatment in Center for Reproductive Medicine,Shandong University from June 2013 to June 2015.They were divided to two groups according to the presence or absence of abnormal lipid metabolism to evaluate whether abnormal lipid metabolism can develop the severe OHSS.The main measures in this study include the incidence of moderate OHSS and severe OHSS,age,body mass index(BMI),number of retrieved oocytes and total dose of gonadotrophin(Gn).In addition,all the participants were divided to two according to whether received the fresh embryo transfer after controlled ovarian hyperstimulation.Results:(1)In the overall patients with OHSS,the ones with abnormal lipid metabolism are more likely to develop to severe OHSS presenting more serious clinical manifestations in the untransplanted groups(35.0%vs.19.5%)with statistical difference(P<0.05).The dose of Gn as well as BMI of patients with normal lipid metabolism were markedly lower than those of patients in abnormal lipid metabolism group(P<0.05).Age and BMI of two groups had no statistical difference(P>0.05).(2)The incidence of severe OHSS among transplanted groups had no statistical significance(38.46%vs.32.7%,P>0.05).In addition,age,total does of Gn,number of retrieved oocytes and BMI had no statistical difference(P>0.05).(3)The rate of OHSS development was significantly higher in the patients who received fresh cycle embryo transfers comparing to the frozen-thawed embryo transfers(38.5%vs.26.1%,P<0.05).The number of retrieved oocytes in patients of fresh embryo transfer were dramatically less than the other group(P<0.05).Age,otal does of Gn and BMI of two groups had no statistical difference(P>0.05).Conclusions:Our study results suggest that patients with OHSS combined with abnormal lipid metabolism who received embryo transfers at once after controlled ovarian hyperstimulation have a higher chance of developing to severe OHSS.The incidence of severe OHSS among the patients with fresh embryo implantation had no statistical difference between two groups.It is essential to consider the risk of occurrence of OHSS in patients with abnormal lipid metabolism required fresh embryo transfers.