Effects Of Weight Loss On Pregnancy Outcome,TCM Syndrome Score,Th1/2/17 Cytokines And NK Cells Activity In Obese PCOS Patients With Repeated Implantation Failure

[Objective]To study the effect of weight reduction on consequence of gestation,TCM syndrome score,Th1/2/17 cytokines and NK cells in obese PCOS patients with repeated implantation failure,so as to provide reference for future treatment.[Method]1.From November 2017 to February 2020,215 obese PCOS patients were collected from RIF reproductive center of the First Affiliated Hospital of China University of science and Technology(Anhui Provincial Hospital).On the basis of the extent of weight loss,the 215 sufferers were partitioned into four groups:group A(0<weight loss≤5kg),group B(5kg<weight loss≤10kg),group C(10kg<weight loss≤15kg)and control group(without successful weight reduction and recombination).The age,infertility age,BMI,weight,pregnancy outcome and TCM syndrome score of the four groups were compared.2.60 weight-loss patients with BMI of 25-30kg/m~2 and age of 23-35 years old who were to receive IVF from September 2018 to February 2020 were collected.Flow cytometry was used to detect NK cells and Th1/2/17 cytokines,and the diversities among the four groups were dissected.[Results]1.Comparison of general informations:There were no conspicuous discrepancy in age,infertility age,BMI and body weight before and after the intervention among the four groups(P>0.05).2.Comparison of TCM syndromes:According to the statistics of 215 cases of TCM syndromes,a total of 108 cases were diagnosed as spleen deficiency and phlegm dampness type,accounting for 50.23%(108/215),while phlegm-stasis cementation,spleen deficiency and liver depression and kidney deficiency and blood stasis accounted for 22.32%,18.14%and 8.84%respectively,there was no conspicuous discrepancy between the groups(P>0.05).There was no conspicuous discrepancy in TCM syndrome score among the four groups before intervention(P>0.05),but after intervention,there was no conspicuous discrepancy in phlegm-stasis cementation(P>0.05),considering that the number of cases was relatively small.The scores of other syndromes in the three groups after successful weight loss which were conspicuously lower than in the control group,and there was conspicuous discrepancy between the two groups(P<0.05),and the discrepancy was more conspicuous in the 10-15kg group.3.Comparison of consequence of gestation:There was no conspicuous discrepancy among the four groups(P>0.05),but in the group B(5kg<weight loss≤10kg)and group C(10kg<weight loss≤15kg),the embryo implantation rate and cumulative clinical pregnancy rate were higher than control group,while the abortion rate was lower,and the discrepancy was statistically conspicuous(P<0.05).4.Comparison of NK cell indexes:There was no conspicuous discrepancy among the four groups before the intervention(P>0.05).After the intervention,the proportion of NK,activity,Granzyme B and IFN-g in the three groups of successful weight loss were conspicuously decreased,while those in the control group were all increased.The discrepancies between the two groups of group B(5kg<weight loss≤10kg)and group C(10kg<weight loss≤15kg)were statistically conspicuous(P<0.05),while those in The CD107a group were increased and the discrepancy was statistically conspicuous(P<0.05).5.Comparison of Th1/2/17 cytokines:There was no conspicuous discrepancy among the four groups before the intervention(P>0.05).After the intervention,the three groups of successful weight loss decreased conspicuously in IL-2,IL-6,TNFα,IFN-γand IL-17A,and the discrepancy within and between the groups was statistically conspicuous(P^0.05),the discrepancy of the group C(10kg<weight loss≤15kg) was greater,while the discrepancy in the control group was increased,while in IL4 and10,the discrepancy among the four groups was conspicuous(P<0.05),there was no significant discrepancy between the two groups(P^0.05).[Conclusion]In the obese PCOS patients with repeated implantation failure,successful weight loss can significantly improve the clinical pregnancy rate and TCM syndrome score,reduce the proportion and toxic activity of NK cells,and reduce the level of Th1inflammatory factor,but has no significant effect on Th2.At the same time,the clinical effect of 10-15kg weight loss is more obvious.