Objective:

2

To study the clinical efficacy of Wenyang Lishui Formula (WYLSF) in preventing ovarian hyperstimulation syndrome (OHSS) and explore the suitable range of estradiol (E

2

) on the human chorionic gonadotropin (HCG) day in patients with OHSS using WYLSF.

Methods:

2

Part Ⅰ: eligible patients at high risk for OHSS undergoing ovulation induction between January and December

2023 were randomized into 2 groups based on the actual treatment. The treatment group received 200 mL WYLSF formula twice daily for 5 days after oocyte retrieval in a combination of lifestyle coaching (LC) intervention including regular diet and exercise

whereas the LC group received LC intervention alone. The incidence of OHSS

OHSS self-assessment scales

changes in E

2

levels on HCG day and 5 days after oocyte retrieval

ovarian morphology changes

and menstrual recovery were compared between the two groups. Part Ⅱ: patients at high risk for OHSS treated with WYLSF were studied. The optimal E

2

threshold on the HCG day was determined using the maximum selection test

and a multivariate analysis was adopted to compare the relationship between different E

2

levels on HCG day and hospitalization rate

incidence of moderate to severe OHSS

and self-assessment scales

to explore the preventive effect of WYLSF on OHSS in patients with varying E

2

levels.

Results:

2

A

total of 120 patients were included in the Part Ⅰ analysis. The treatment group (60 cases) showed a significant reduction in the incidence

duration

and severity of abdominal distension

as well as the incidence of vomiting compared with the LC group (

P

<

0.05). The post-retrieval E

2

levels in the treatment group decreased significantly more (

P

=0.032). Among 1

652 patients treated with WYLSF in the Part Ⅱ

90 patients with ≤10092 pmol/L

159 with

>

31074 pmol/L

and 1

403 in the middle range group were formed based on E

2

levels on HCG day in Part two analysis. Univariate and regression analyses showed that patients with E

2

levels

>

31073 pmol/L had a significantly higher incidence of moderate to severe OHSS compared to those with E

2

levels ≤10092 pmol/L (

P

<

0.05).

Conclusions:

2

WYLSF can effectively reduce specific symptoms in high-risk OHSS patients after ovulation induction and significantly lower E

2

levels. It may be more suitable for high-risk OHSS patients with E

2

levels

<

31073 pmol/L on HCG day. (Registration No. MR-11-23-032493

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