Evaluation Of The Correlation Between Homocysteine Levels And Early Pregnancy Loss In PCOS Patients

Objective:To discover the related risk factors and predictors in early pregnancy loss in PCOS patients, by exploring the correlation between the HCY level and early pregnancy loss.Methods:270patients diagnosed with early pregnancy loss or PCOS patients were select from Obstetrics and gynecology clinic outpatients during March2012to March2013. All of these patients were divided into three groups. In abortion group65patients were diagnosed with PCOS, and58patients in PCOS without abortion group, and147patients in non-PCOS abortion group. Data of height, weight, FBS, FINS, HCY levels and the relevant serological factors in patients with pregnancy loss were collected. Patients with PCOS were treated with Diane-35or Marvelon, PCOS patients with insulin resistance were treated addition of metformin, and the HCY, FBS and FINS levels were measured three months later. The data was analyzed with SPSS17.0using two independent samples t test, risk factor analysis was performed with the logistic regression equation and Pearson correlation analysis.Results:1. PCOS abortion group patients have higher HCY levels than non-PCOS abortion group patients and PCOS without abortion group, patients with twice or more abortion have significantly higher HCY level than patients with only once abortion.2. Comparing the data in PCOS abortion group and PCOS without abortion group, the weight, BMI, INS, HOMA-IR, HCY levels differences has statistical significance (P<0.01), and the difference between age, height, FBS, FSH, LH, LH/FSH, E2, T level has no statistical difference (P>0.05). 3. The high HCY level is one risk factor for early pregnancy loss in PCOS patients。4. HCY levels were correlated with BMI, HOMA-IR and the testosterone levels, the coefficient of correlation were0.364(P<0.05),0.551(P<0.05),0.498(P<0.05) respectively.BMI were correlated with HOMA-IR, the coefficient of correlation were0.368(P<0.05).5. Before and after the treatment of contraceptives and metformin in PCOS patients with insulin resistance, FBS has no significant changes (P>0.05), and FINS (P<0.01), HOMA-IR (P<0.01), and HCY levels (P <0.05) have significant difference.Conclusions:1. High HCY levels maybe one risk factor lead to early pregnancy loss, with increased HCY level, increased incidence of early pregnancy loss. HCY level can be used as an indicator to predict early pregnancy outcomes in PCOS.2. PCOS patients with high HCY levels may be associated with obesity, insulin resistance and high androgen hematic disease, and further increase the early pregnancy loss rate.3. The treatment by contraceptive and metformin in insulin resistance of PCOS patients may back to insulin resistance and reduces the HCY levels, which were beneficial to reduce the early pregnancy.