Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Prediction and Prevention of Ovarian Hyperstimulation Syndrome

난소과자극증후군의 예측과 예방

  • Kim, Hye-Ok (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine) ;
  • Kang, Inn-Soo (Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University School of Medicine)
  • 김혜옥 (관동대학교 의과대학 제일병원 산부인과 불임생식내분비분과) ;
  • 강인수 (관동대학교 의과대학 제일병원 산부인과 불임생식내분비분과)
  • Received : 2010.12.21
  • Accepted : 2010.12.28
  • Published : 2010.12.31
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Abstract

Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of ovulation induction. Before ovarian stimulation, identification of patients vulnerable to developing OHSS is necessary. And ovarian stimulation should be started with low doses of gonadotropin or GnRH antagonist protocol. During monitoring of ovarian stimulation with risk of OHSS, coasting, low doses hCG and GnRH agonist for triggering ovulation are considered. If severe OHSS is predicted, cycle cancellation and cryopreservation of all embryos should be considered to reduce late-onset OHSS and morbidity. And metformin and dopamine agonist for reducing OHSS are being proposed as a prophylactic treatment for OHSS.

난소과자극증후군은 발생 시 생명을 위협하는 심각한 의인성 합병증으로, 불임 치료를 목적으로 성선자극호르몬을 사용하여 과배란을 유도할 때 발생한다. 따라서, 과배란 유도를 하기에 앞서 위험요인을 가진 환자를 파악하여 저용량의 성선자극호르몬을 사용하거나, GnRH antagonist protocol을 이용함으로써 발생을 예방하는 것이 중요하고, 과배란 유도 중 ovarian hyperstimulation syndrome (OHSS)의 발생이 예측될 때는 성선자극호르몬 투여 시 coasting을 하고 난포 성숙을 유도할 때 저용량의 hCG 혹은 GnRH agonist를 이용하고, 중증의 OHSS가 예측될 때에는 주기취소로 OHSS의 유병기간을 줄이거나 배아동결 등을 통해 후발성 난소과자극증후군을 예방할 수 있다. 그리고, metformin과 dopamine agonist를 난소과자극증후군을 예방을 위해 고려해 볼 수 있겠다.

Keywords

References

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