| Background and purposeAt the present stage,studies have found that the incidence of female infertility is gradually increasing with the rapid development of economy,and ovulation disorders represented by polycystic ovary syndrome are the main causes of infertility in women of childbearing age.In clinical practice,ovulation induction therapy is often used to improve the clinical pregnancy rate of PCOS infertility patients.This clinical trial mainly investigated the influence of serum AMH level and basic sex hormones(FSH,LH,E2,P)level on ovulation induction treatment outcome in PCOS infertile patients,and the relationship between serum AMH level and basic sex hormones(FSH,LH,E2,P).MethodsA total of 106 infertile patients were collected from September 2020 to December 2021 who received ovulation induction treatment in the Outpatient department of Reproductive Center of the Second Affiliated Hospital of Harbin Medical University and met the criteria of platoon induction.It is divided into three groups according to the patient’s AMH value:In group A,there were 45 patients(AMH<3 ng/mL),including 3 patients with PCOS and 42 patients with non-PCOS,and 31 patients(AMH3-6ng/mL)in group B,including 17 patients with PCOS and 14 patients with non-PCOS,30 patients(AMH>6ng/mL)in group C,including 28 patients with PCOS and 2 patients with non-PCOS.Patients with irregular menstruation were given Diane-35 to adjust their menstrual cycle 2-3 cycles before ovulation induction therapy.All the infertility patients included in the study were tested for basic sex hormones(FSH,LH,E2,P)2-5 th day of menstruation,Letrozole(Fleur)5 mg QD was taken orally on the 5 th day of menstruation and was taken continuously for 5 days.On the 10th day,follicle size was monitored by vaginal ultrasound every other day.When at least one follicle diameter≥18 mm,the patient was instructed to self-test urine LH test paper.When the urine LH test paper showed positive(+)or weak positive(±),6000-10000IU HCG was intrasmusally injected according to the number of follicles,and the number and size of dominant follicles on the day of HCG were recorded,and the patient’s husband and wife were instructed to have a room together.After 3 6-4 8 hours of HCG injection,follicle excretion was monitored by negative color doppler ultrasound,to guide the luteal support treatment after ovulation,continue to follow up the outcome of ovulation promotion,and finally analyze the correlation between the differences of observation indicators among the three groups of patients.Results1.AMH was positively correlated with the number of eggs obtained after ovulation induction treatment.The younger patient was,the better ovarian reserve function was,the higher AMH value was,the more eggs were obtained after ovulation induction(R=0.552,P<0.001),with the pregnancy probability was higher,the abortion rate was also higher.And the serum AMH value of PCOS patients was higher than that of non-PCOS patients.2.FSH is an essential hormone for follicular growth and development.With follicular growth,estrogen secretion reaches its peak,and positive feedback causes LH peak to trigger ovulation.Basic sex hormone LH is positively correlated with the number of eggs obtained after ovulation induction treatment(R=0.561,P<0.001),but the basic hormones FSH,E2 and P had no correlation with it,there was no significant difference(P>0.05).3.This study found that there were no significant differences in BMI,basic sex hormones E2,P and other related indicators among the three groups(P>0.05).Serum AMH was positively correlated with basic sex hormone LH(r=0.663,P<0.001)while AMH was negatively correlated with basic sex hormone FSH(r=-0.364,p<0.001),and the difference was statistically significant.4.In the process of ovulation induction and pregnancy promotion,compared with non-PCOS patients,serum AMH value and basic sex hormone LH value were higher in PCOS patients,and the number of follicles obtained after ovulation induction was more,with statistical significance(P<0.05).There was no significant difference in ovulation induction outcome(pregnancy rate,abortion rate)、BMI and basic hormones FSH,E2 and P between PCOS patients and non-PCOS patients(P>0.05).Conclusions1.Serum AMH level and basic sex hormone LH were positively correlated with ovulation number of PCOS patients after ovulation induction treatment,while serum basic sex hormones FSH,E2,P had no correlation with it,and serum AMH level was positively correlated with pregnancy rate and abortion rate,serum AMH had certain guiding significance for evaluation of ovulation induction treatment efficacy.2.There is a positive correlation between AMH and basic sex hormone LH,AMH was negatively correlated with age and basic sex hormone FSH,and had no obvious correlation with basic sex hormones E2 and P. |
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