阅读说明：本技术 用于卵巢过度刺激综合症预防治疗的序贯药物及使用方法 (Sequential medicine for preventing and treating ovarian hyperstimulation syndrome and using method ) 是由 徐仙 李永丽 陈耀平 于 2019-12-18 设计创作，主要内容包括：一种用于卵巢过渡刺激综合症预防治疗的序贯药物及使用方法,其特征在于,在对中重度卵巢过度刺激综合症患者促排卵时,开始给予强的松、二甲双胍和醋酸泼尼松预处理给药,采卵后继续应用上述药物及羟乙基淀粉氯化钠注射液药物综合对症治疗,经过一系列预防OHSS药物序贯组合治疗,同时胚胎实验室进行受精卵囊胚培养第5-6天后实施新鲜周期移植,不仅提高了胚胎利用率和临床妊娠率,而且降低了胚胎冷冻率,尤其是中重度OHSS病情有效控制,取得了突破性的治疗进展,实现了既能新鲜周期同步胚胎移植又能合理控制OHSS发生发展的门诊治疗组合方案的理想目标。(A sequential medicine for preventing and treating ovarian hyperstimulation syndrome and a using method thereof, which is characterized in that, when ovulation promotion is carried out on a patient with moderate and severe ovarian hyperstimulation syndrome, pretreatment administration of prednisone, metformin and prednisone acetate is started, the medicine and the hydroxyethyl starch sodium chloride injection are continuously applied to symptomatic treatment of drug syndrome after egg collection, sequential combination treatment of a series of OHSS (OHSS) prevention medicines is carried out, meanwhile, the embryo laboratory carries out fresh period transplantation after the fertilized egg blastocyst is cultured for 5 to 6 days, thereby not only improving the utilization rate of the embryo and the clinical pregnancy rate, and the embryo freezing rate is reduced, particularly the effective control of the moderate-severity OHSS disease condition is achieved, breakthrough treatment progress is achieved, and an ideal target of an outpatient treatment combination scheme which can not only perform fresh cycle synchronous embryo transplantation but also reasonably control the occurrence and development of OHSS is realized.)

1. A sequential medicine for preventing and treating ovarian hyperstimulation syndrome is characterized in that when ovulation promotion is carried out on a patient with moderate and severe ovarian hyperstimulation syndrome, pretreatment administration of prednisone, metformin and prednisone acetate is started, after egg collection, the medicine and hydroxyethyl starch sodium chloride injection medicine are continuously applied for symptomatic treatment of the syndrome, sequential combination treatment of a series of OHSS prevention medicines is carried out, and meanwhile, fresh cycle transplantation is carried out after 5-6 days of oothecal embryo culture in an embryo laboratory.

2. The use method of the sequential medicine for preventing and treating the ovarian hyperstimulation syndrome is characterized by comprising the following specific use method and flow:

(1) assessment of high risk factors for OHSS development and dynamic monitoring and early prediction in ovulation-promoting therapy;

(2) sequential combination therapy with drugs for early prevention of OHSS;

(3) accurate diagnosis of OHSS (OHSS) on egg-taking day and intravenous intervention treatment of hydroxyethyl starch and sodium chloride injection;

(4) culturing blastocysts in an embryo laboratory;

(5) implementing the technical scheme of single-sac embryo transplantation of a clinician;

(6) the development of OHSS occurs in outpatient follow-up.

3. The sequential medicine for preventing and treating transient ovarian stimulation syndrome according to claim 1, wherein the sequential medicine and the using method thereof are specifically as follows: prednisone acetate tablets are orally taken 5-15mg per day, aspirin enteric-coated tablets are orally taken 25-75mg per day, metformin tablets are orally taken 1000-1500mg per day, bromocriptine tablets are orally taken 2.5 mg per day, and hydroxyethyl starch sodium chloride injection is intravenously dropped 500-1000ml per day.

4. The method of claim 2, wherein the range of high risk factor assessment for OHSS development comprises antral follicular number, anti-muller and body mass index.

5. The method for using sequential drugs for preventing and treating transient ovarian stimulation syndrome as claimed in claim 2, wherein 4-5 frozen high quality embryos are selected on the third day of embryo culture in blastocyst culture in embryo laboratories; blastocyst transfer or blastocyst freezing was performed on the fifth day of blastocyst culture.

Technical Field

The invention belongs to the field of medical drugs, and particularly relates to a sequential drug for preventing and treating ovarian hyperstimulation syndrome and a using method thereof.

Background

In the in vitro fertilization-embryo transfer cycle treatment, ovarian hyperstimulation syndrome (OHSS) is one of the most common complications due to ovulation-promoting treatment. For OHSS patients, the majority of clinical treatment strategies are to eliminate fresh cycle embryo transfer and perform whole embryo freezing. However, the following negative events occur with the whole embryo freezing without fresh cycle transplantation: (1) the fresh transplantation is cancelled, the damage of the embryo can be increased in the operation process of freezing and recovering the embryo, and a part of the embryo can not normally survive after recovery; (2) the waiting time of the patient can be increased by recovering the frozen embryo transplantation again after the embryo is frozen, the frozen embryo transplantation after waiting for 3 months is expected to be scorched for a long time in the in vitro fertilization-embryo transplantation treatment process of the patient, the inner heart is not specific to anxiety, the heart cutting is expected to be successful as early as possible, and the anxiety cycle of the patient is increased again by the frozen embryo transplantation; (3) the embryo is frozen again after the whole embryo is frozen and then is transplanted, so that the cost of freezing and recovering the embryo is increased, and the economic burden of a patient is increased; (4) increasing the workload on laboratory technicians and the burden on clinicians.

Disclosure of Invention

The invention aims to solve the problems existing in the existing ovarian hyperstimulation syndrome treatment, and provides a sequential medicine for preventing and treating ovarian hyperstimulation syndrome and a using method thereof.

The technical scheme of the invention is as follows: a sequential medicine for preventing and treating the excessive ovarian stimulation syndrome is prepared through pretreating the strong pine, metformin and prednisone acetate for treating the excessive ovarian stimulation syndrome, collecting ova, applying said medicine and the injection of hydroxyethyl starch and sodium chloride, sequential OHSS-preventing medicines, culturing the blastocyst in embryo lab for 5-6 days, and transplanting in fresh period.

The specific using method and the flow of the invention are as follows:

(1) assessment of high risk factors for OHSS development and dynamic monitoring and early prediction in ovulation-promoting therapy;

(2) sequential combination therapy with drugs for early prevention of OHSS;

(3) accurate diagnosis of OHSS (OHSS) on egg-taking day and intravenous intervention treatment of hydroxyethyl starch and sodium chloride injection;

(4) culturing blastocysts in an embryo laboratory;

(5) implementing the technical scheme of single-sac embryo transplantation of a clinician;

(6) the development of OHSS occurs in outpatient follow-up.

The invention has the following beneficial effects:

(1) the method not only improves the utilization rate of the embryo and the clinical pregnancy rate, but also reduces the embryo freezing rate, particularly effectively controls the condition of medium-and-severe OHSS, achieves breakthrough treatment progress, realizes the ideal target of an outpatient treatment combination scheme which can not only carry out fresh cycle synchronous embryo transplantation but also reasonably control the occurrence and development of OHSS, reduces the hospitalization rate of patients, saves the treatment cost and also reduces the workload of medical care personnel.

(2) Early prediction: the patients are subjected to OHSS high-risk factor evaluation and the prediction of early stage of the super ovulation-promoting drug treatment, and are timely treated by oral and external drugs in a sequential combination manner in the early stage of OHSS.

(3) Blocking the occurrence of OHSS: aiming at the generation mechanism of OHSS, corresponding drug combination intervention is adopted for each key link to block the generation and development of OHSS.

(4) Intensive treatment is emphasized: follow-up the OHSS degree again on the egg collecting day, and increase the intensive treatment of venous colloid osmotic pressure.

(5) Time acquisition: the method fully utilizes the lab to obtain a large number of eggs for blastocyst culture, thereby gaining time for effective control of OHSS, prolonging the transplantation to 5-6 days and improving the implantation rate and pregnancy rate.

(6) The medical technique is well matched: the clinician is closely matched with the technical personnel in the laboratory, and the fresh embryo transplantation rate and the embryo utilization rate are improved.

(7) Economic and safe: the treatment period is shortened, the occurrence of moderate-severe OHSS is avoided, hospitalization is reduced, and the economic cost of patients is saved.

(8) The curative effect is improved: the clinical pregnancy rate is improved to 70-80%.

(9) The follow-up visit of the outpatient service is timely: follow-up visits for outpatient service and irregular follow-up visits are facilitated for accompanying patients and family members.

(10) The work efficiency is high: strives for the blastocyst transplantation in a fresh period, and is beneficial to the work arrangement of laboratories and doctors.

Drawings

FIG. 1 is a schematic view of the process of the present invention.

Detailed Description

The embodiments of the present invention will be described with reference to the accompanying drawings.

As shown in figure 1, the sequential medicine and the using method for preventing and treating the ovarian hyperstimulation syndrome firstly evaluate the high risk factors of OHSS occurrence, and the evaluation range comprises the number of antral follicles, the anti-Muller disease and the body mass index; signing a hormone medicine informed contract; evaluating the ovulation induction treatment on the fifth day; a sequential drug treatment combination scheme is established, and the sequential drugs are respectively: prednisone acetate tablets are orally taken 5-15mg each day, aspirin enteric-coated tablets are orally taken 25-75mg each day, metformin tablets are orally taken 1000-1500mg each day, bromocriptine tablets are orally taken 2.5 mg each day, and hydroxyethyl starch sodium chloride injection is statically dropped 500-1000ml each day; entering egg taking and fertilization; signing an OHSS informed consent; selecting 4-5 frozen high-quality embryos on the third day of embryo culture; performing single-blastocyst transplantation or blastocyst freezing on the fifth day of blastocyst culture; and (3) re-diagnosing to evaluate the remission condition of the ovarian hyperstimulation, judging whether blood B-HCG pregnancy exists or not by follow-up visit, and determining clinical pregnancy/number by BUS.

After a series of OHSS prevention medicines are used for sequential combination treatment, the embryo laboratory performs fresh cycle transplantation after fertilized egg blastocyst culture for 5-6 days. The embryo utilization rate and the clinical pregnancy rate are improved, the embryo freezing rate is reduced, particularly the effective control of the moderate-severe OHSS disease condition is realized, the breakthrough treatment progress is achieved, and the ideal target of the outpatient treatment combination scheme which can not only perform fresh cycle synchronous embryo transplantation but also reasonably control the occurrence and development of OHSS is realized.