Clinical Efficacy Analysis Of Patients With Endometriosis Infertility Under IVF-ET And Preliminary Study Of Vitamin E In That Patients

BackgroundEndometriosis, referred to EMT, is the endometrium (glands and stroma)outside the uterus in the site.Endometriosis is a hormone-dependent diseases, can beartificially applied drugs and surgery to slow down and suspend its development.It isbenign histologically, but with planting, invasion and metastasis of malignant tumorsand other similar features in the clinical behavior.The main clinical manifestations arepersistent worsening pelvic adhesions, pain and infertility.In women of childbearingage, the prevalence rate is about25%,21%~44%associated with infertility.Relatedto the pathogenesis of endometriosis and infertility is not fully understood, leading toits therapeutic effect is not ideal.All along, the treatment of the patient with endme-triosis and infertility is surgery and drug, with the development and maturity of assis-tive reproductive technology, has brought new hope for these patients.In clinical work,but found the bed, the success rate of endometriosis infertility patients undergoingassisted reproductive technology is still not ideal, it may be endometriosis pelvicstructure, ovarian function, ovulation, egg quality, sperm-egg binding capacity,endometrium and embryo quality and related environmental impact of all have acertain relationship.In order to explain the pathogenesis of endometriosis andinfertility,to understand the reasons for this kind of patients for assisted reproductivetechnology of the low success rate,the role of oxidative stress in endometriosis has attracted more and more attention.Oxidative stress and the occurrence anddevelopment of various body disease are inseparable, in the infertile womenundergoing assisted reproduction in the role and endometriosis in infertility patientscan play a similar place, in recent years, the various research confirmed that thefunction of oxidative stress in the patients with endometriosis.Vitamin E know as anantioxidant, has been widely applied to agriculture and life, but its application in thefield of assisted reproductive technology has not been widely recognized. For vitaminE dose and the time is still controversial.This paper will explore the impact of endometriosis severity of IVF-ET,understanding endometriosis may affect the success rate of infertility patientsundergoing IVF-ET from what aspects; addition, the use of antioxidant vitamin Ereduced oxidation endometriosis infertility patient stress level, to explore its clinicalapplication in the foreground.ContentPart Ⅰ The analysis of endometriosis infertility patients with IVF-ET outcomeObjectiveInvestigate the effects of endometriosis on IVF-ET, the severity of endometriosisin the preliminary analysis of the impact of such patients with IVF-ET outcome fromwhat aspects.MethodsCollected from January2012to December2013in Guangdong Province duringthe MCH Division of Reproductive Health and Infertility accepted IVF-ET treatmentof endometriosis infertility patients92cases. IVF treatment before laparoscopy orlaparotomy were performed to determine the staging of endometriosis.Different stagesof endometriosis the subjects were divided into two groups, A group (65cases) as endometriosisⅠ,Ⅱpatients in group B (27patients) wasⅢ,Ⅳpatients. Study subjectswere first accepted IVF-ET treatment, preoperative B-recurrence of endometriosis arenot prompted and the exclusion of other systemic polycystic ovary syndrome andother endocrine diseases.Group C (154patients) for the same period due to arandomly selected patients with bilateral tubal occlusion line IVF-ET, excluding othersystemic endocrine diseases such as polycystic ovary syndrome.All subjectsunderwent controlled ovarian hyperstimulation long regimen IVF-ET, the basicbackground of each group were compared between ovarian hyperstimulation andclinical outcomes. Results Application SPSS19.0statistical software package forstatistical analysis. Each group using the t test between the number of each groupwere compared using the chi-square test rate. P<0.05was considered statisticallysignificant.Results1.Age, duration of infertility, basic FSH, LH and E2levels of infertility patients ineach group were not statistically significant (P>0.05).2.Each group in the course of ovarian hyperstimulation, HCG Day E2levels andendometrial thickness transplant date no significant differences; With the aggravationof endometriosis, Gn and Gn amount of time showed an increasing trend, the numberof oocytes is decreased, where Gn dosage group B and the number of oocytes changedsignificantly compared with group C, was statistically significant (P <0.05).3.Comparing groups A and B, respectively, with the control group, two groups ofpatients with the fertilization rate of IVF-ET, high quality embryo rate, implantationrate and clinical pregnancy rate has reduced, but the difference was no significantdifference (P>0.05).Conclusions 1.Endometriosis causes of infertility in patients with ectopic lesions may be mainlyaffected the patient’s internal environment.2.IVF-ET is an effective technique to improve the chance of pregnancy in thesepatients, but the success rate of its line of IVF-ET was low compared with tubalfactor. Part Ⅱ Explore the effect of vitamin E endometriosis infertilitypatients on IVF-ETObjectiveTo investigate the effect of vitamin E for the treatment of endometriosis,infertility, IVF-ET patients and provide a theoretical basis for its clinical application.MethodsSelected in August2013to February2014in patients with endometriosis andChild Health Hospital of Guangdong Province Branch Line reproductive health andinfertility IVF-ET prospective case-control study conducted for the study. Studysubjects were by laparotomy or laparoscopy confirmedⅠ,Ⅱstage endometriosispatients before surgery IVF-ET examination found no recurrence of endometriosisand adenomyosis patients excluded.Which give vitamin E in patients withendometriosis as the study group, no patients with endometriosis given vitamin E as acontrol group. All subjects are used to adjust the mid-luteal down long program, intwo groups of patients outside COH day collecting peripheral blood and follicularfluid, using the colorimetric method, xanthine oxidase (hydroxylamine) andchemical groups of patients were measured fluorescence serum and follicular fluidvitamin E (VE), superoxide dismutase (SOD) and reactive oxygen species (ROS) levels. Clinical outcomes were compared between oxidative stress indicators and theabove correlation with clinical outcome. Results Application SPSS19.0statisticalsoftware package for statistical analysis of experimental data. Count data using thechi-square test, measurement data using independent sample t test, experimental dataand clinical evaluation line correlation analysis, represented by Spearman correlationcoefficient. P <0.05was considered statistically significant.Results1.Study of serum and follicular fluid levels of VE were significantly higher than thecontrol group in serum and follicular fluid, it was statistically significant (P <0.05), aswell as the study group SOD levels and ROS levels did not significantly higher thanthe control group, it is no statistically significant (P>0.05).2.Study group and the control group, the level of VE in serum was significantly higherthan the follicular fluid, SOD levels in follicular fluid were significantly higher thanthe serum, it has a significant difference (P>0.05).3.The average number of oocytes and clinical pregnancy rates were not statisticallysignificant between the study group and the control group(P>0.05). Fertilization rateand good quality embryo in research group is higher than the control group,implantation rate in study group is higher than the control group, but it is notstatistically significant (P>0.05).4.In the control group, serum and follicular fluid of VE, SOD and ROS levels andIVF-ET outcome evaluation correlation analysis showed that serum and follicularfluid levels of ROS and IVF-ET outcome evaluation was negatively correlated withthe trend, which in follicular fluid ROS levels were negatively correlated with theimplantation rate was statistically significant (P <0.05). However, SOD and outcomeevaluation found a negative correlation. Study group, ROS in serum and IVF-EToutcome evaluation is essentially a negative correlation trend, but no significant difference (P>0.05). Overall, VE, SOD and ROS of the control group and studygroup and IVF-ET outcome evaluation of little relevance.ConclusionsThe presence of endometriosis in vivo oxidative stress in infertile patients bysystemic or follicle damage the local environment, which in turn affect the outcome ofIVF-ET lines; adding vitamin E to patients with endometriosis infertility in IVF-ETthe effect is not clear, may be related to the nature of the original oxidation of vitaminE is related to vitamin E dose and treatment time still need further improvement.