The Relative Factors Of Ovarian Response Incontrolled Ovulation Hyper-stimulation

Objects To discover the influencing factor of poor response and the interrelationship between these factors and poor response. Hormonal level,cell factor vascularendothelial growth factor (VEGF), Insulin-like growth factor 1 (IGF-â… ), Stem cell factor(SCF )in serum and follicular fluid and granulosa cell apoptosis during the poor response group and the normal response group in Controlled ovulation hyper-stimulation (COH) were studied.The purpose is to improve the response of ovarian and finally develop the rate of conception.Methods The total of 72 infertile patients treated with in vitro fertilization embryo transfer (IVF-ET) were devided into two groups, among them 29 were poor response and 43 were normal response . The level of hormonal ,VEGF,IGF-â… ,and granulosa cell apoptosis in serum and follicular fluid were analysed by using RIA,ELISA,and FCM.Data were statistics and analysed by t-test and pearson relative analyse with SPSS13.0 software.Results1. Basal FSH in poor response group is higher than that in normal group(P=0. 047); FSH,FSH/LH,E2 on the third day of menstruation is higher in poor response group than in normal group (P=0.04,P=0.038,P=0.043);And lower on the eighth day of menstruation,HCG day in poor response group than in normal group(P=0.044 ;P=0.001).2. The density of IGF-â… and SCF in poor response group is lower than that in normal group in serum(P=0.016;P=0.020);But there is no difference of VEGF between the two group(P>0.05).3. The density of VEGF and IGF-â… in poor response group in follicular fluid is higher than those in normal group(P=0.001;P=0.005); But the density of SCF in poor response group is lower than that in normal group both in follicular fluid(P=0.026).4. The apoptosis rate in poor response group is higher than normal group(P=0.009).5. There is positive correlation of SCF in serum and in follicular fluid (r=0.565,P=0.002).6. There is negatively correlation between E2 and the apoptosis rate in serum(r=-0. 582,P=0.001;anaphase r=-0.526,P=0.002)and positive correlation with FSH/LH after down regulation(r=0.599,P=0.001).But there is no correlation between VEGF ,IGF-â… ,SCF either in follicular fluid or in serum and granulosa cell apoptosis ratio(P>0.05).Conclusions1. The higher density of VEGF in follicular fluid that may caused by ovarian may participate the pathogenesy of poor response.2. The lower density of IGF-â… in serum may be the one reson of the pathogenesy of poor response.But the less follicular recruitment number may cause the rising of the density of IGF-â… in follicular fluid.3. The lower density of SCF in follicular fluid and in serum may be the one reson of the pathogenesy of poor response.4. Granulosa cell apoptosis might affect the response of ovarian, exorbitant level of FSH may affect the response of ovarian by cell apoptosis path.