Analysis Of The Effect Of Ovarian Chocolate Cyst And Laparoscopic Surgery On The Pregnancy Outcomes Of In Vitro Fertilization And Embryo Transfer In Infertile Patients

ObjectiveThis study retrospectively analyzed the clinical data of in vitro fertilization and embryo transfer(IVF-ET)in infertile patients with ovarian chocolate cyst.To explore the effect of ovarian chocolate cyst on IVF-ET outcome and the effect of laparoscopic cystectomy on IVF-ET outcome.The mean number of oocytes retrievedMethodFrom January 2017 to December 2019,the clinical data of IVF/ICSI infertile patients were analyzed retrospectively.The study group was as follows: ovarian chocolate cyst with infertility(according to the history of surgery,divided into ovarian chocolate cyst group and laparoscopic cystectomy group),and the control group was infertile by simple fallopian tube factor or male factor.Exclusion criteria :(1)Except for chocolate cysts,Like polycystic ovary syndrome,premature ovarian failure,recurrent implantation failure;(2)History of uterine and adnexal surgery in addition to laparoscopic cystectomy;(3)Patients with the use of donor sperm or donor oocyte 、 chromosomal abnormality patients;(4)Data were incomplete or no pregnancy outcome was observed at the follow-up date.According to the diagnosis and medical history of the patients were divided into groups: Ovarian chocolate cyst group(n=97): infertility patients was diagnosed as ovarian chocolate cyst by medical history and ultrasound,without any surgical treatment;Control group 1(n=97): infertile patients with tubal or male factors during the same period,according to the principle of matching the age and BMI of the patients in the group,the selection was 1:1.Laparoscopic cystectomy group(n=152): laparoscopic ovarian chocolate cyst excision,Post operative pathological diagnosis of ovarian chocolate cyst patients;Control group2(n=152): infertile patients with tubal or male factors during the same period,According to the principle of matching the age and BMI of the patients in the operation group,the selection was 1:1.The observational indicators included the general condition 、controlled ovarion hyperstimulation and clinical outcome of patients.ResultsComparison of ovarian chocolate cyst group and control group 1 patients,the number of AFC was less than(P<0.05)in control group 1,the total Gn use was more than control group 1(P<0.05).Other observation indicators were not statistically different(P>0.05)between the two groups.Compared with control group 1 and unilateral chocolate cyst group,the b-FSH of bilateral ovarian chocolate cyst group was higher,The difference was statistically significant(P=0.002 and P=0.014).The AFC of unilateral and bilateral chocolate cyst group were less than that of control group 1(P=0.012 and P=0.004).The total amount of Gn used in bilateral chocolate cyst group was more than that in control group 1(P=0.001).and the number of oocytes obtained in the bilateral chocolate cyst group was less than that in the control group1(P<0.001).Other observation indicators of the three groups were not statistically different(P>0.05).The results of multiple linear regression analysis on the number of oocytes obtained in the chocolate cyst group showed that the number of oocytes obtained in the patients with ovarian chocolate cyst was statistically correlated with age and AFC、b-FSH(p<0.05).The AFC was positively correlated with he number of oocytes obtained and negatively correlated with age and b-FSH.The b-FSH of operation group was higher than control group 2(P>0.05)),The total Gn use in the laparoscopic cystectomy group was more than the control group 2(P>0.05),The number of AFC,the number of oocytes obtained and number of available embryos in the laparoscopic cystectomy group were less than that in the control group 2(P>0.05).There was no statistical difference between the other observation groups(P>0.05).Patients in unilateral laparoscopic cystectomy group(n=99),bilateral laparoscopic cystectomy group(n=53),and control group 2(n=152)were compared,the number of AFC in bilateral laparoscopic cystectomy group was less than that in control group 2(P=0.007),the number of oocytes obtained was significantly lower than the control group 2(P=0.003);The number of available embryos in unilateral laparoscopic cystectomy group and bilateral laparoscopic cystectomy group was less than that in control group 2,difference was statistically significant(P<0.001).There was no significant difference between the other groups(P>0.05).The results of multiple linear regression analysis affecting the number of oocytes obtained in the laparoscopic cystectomy group showed that the number of oocytes obtained in the laparoscopic cystectomy group was statistically correlated with AFC、AMH、the spacing of oocyte extraction time after operation(P<0.05).Among them,the AFC、AMH was positively correlated with the number of oocytes obtained,and negatively correlated with the spacing of oocyte extraction time after operation.Conclusion1.The ovarian chocolate cyst does not affect the number of oocytes obtained from the infertile patients,nor does it affect the clinical outcome of IVF-ET.The number of oocytes obtained in the patients with ovarian chocolate cyst was statistically correlated with age and AFC、b-FSH.The AFC was positively correlated with he number of oocytes obtained and negatively correlated with age and b-FSH.2.Laparoscopic cystectomy group affect the number of oocytes obtained and ovarian function,but not affect the clinical pregnancy outcome of IVF-ET.the number of oocytes obtained in the laparoscopic cystectomy group was statistically correlated with AFC、AMH、the spacing of oocyte extraction time after operation.the AFC、AMH was positively correlated with the number of oocytes obtained,and negatively correlated with the spacing of oocyte extraction time after operation.