The Dynamics Variatious Of Inhibin B Hormone In Polycystic Ovarysyndrome During Controlled Ovarian Stimulation And The Relationship Beween INH-B And The Gonadotropin Dose

Objective:To explore the dynamics variatious of inhibin B(INH-B) in patients with polycystic ovary syndrome(PCOS) in the course of controlled ovarian stimulation(COS).Analysis the relationship between the basal serum levels of INH-B and the total dose of Gn during the COS.Analysis the correlation between the increment of serum inhibin B and the dosage of Gn and the number of oocytes.To determine the predictive value of the serum and follicular fluid INH-B lever to the outcome of in vitro fertilization- embryo transfer(IVF-ET).Method:We choose pations who undegoing IVF-ET of Reproductive Center of Second Hospital of Hebei Medical University for tubal obstruction between December 2013 to January 2015.In the research a total of 120 patients was accept:90 patients who was diagnosed PCOS were enrolled into the experimental group,while 30 non-PCOS patients were accept to the control group.We collected the blood samples of all the patients on the third day of the menstrual(Day3),the day start to administrate exogenous gonadotropin(Gn day),five days later of the Gn day(Gn5 day)and the day of HCG injection(HCG day)respectively,and on the oocyte retrieval day,follicular fluid was collected.We measured the level of serum INH-B in different time(Day3,Gn day,Gn5 day and HCG day),we record the total dosage of Gn,the levels of basic FSH, the duration of COS,the number of oocyte retrived the number of transferrable embryo and the outcome of pregnancy.According to the increment of serum INH-B(Gn5 day minus Day3),PCOS patients were divided into low ΔINH-B,moderate ΔINH-B and high ΔINH-B group.We compared the clinical characteristics and the outcome amone the three groups.Result:To compare with the control group,the serum level of INH-B is higher in the PCOS group,regardless Day3,Gn day,Gn5 day and HCG day,the follicular fluid level of INH-B is higher in the PCOS group also,the difference was statistically significant(P<0.01).In the PCOS group,the serum levels of INH-B on the Gn day is lower than the serum levels of INH-B on Day3 lower,the difference was statistically significant(P<0.05).On the Gn5 day serum INH-B levels is increased compare with Day3, the difference was significant(P<0.05).On the HCG day serum INH-B levels is increased compare with Day3,and the difference was statistically significant(P<0.01).The trend exists in the control group also.In our research,it demonstrate that the total Gn dose is higer in PCOS group,and the difference was statistically significant(P<0.05).It shows negative correlation beween the basis serum INH-B and the total dose of Gn in the PCOS group(r=-0.274,P=0.034).According the body mass index(BMI)we divided all the patiens into overweight group and non-overweight group,it display that the basal serum INH-B is lower in the overweight group(P<0.05).The serum INH-B increment between Day3 and Gn5 day(ΔINH-B),then we divided the PCOS group into low ΔINH-B group(group A),moderate ΔINH-B group(group B)and high ΔINH-B group(group C),we administrate less total Gn dose and more eggs in group A compare with group B and C,with statistically significant difference(P<0.05).In the control group, the number of transferrable embryo, the level of serum INH-B in Gn day and follicular fluid INH-B levels were higher in the pregnant patients than the non-pregnant patient,the difference was statistically significant(P<0.01).The level of serum INH-B in Day3,Gn5 day and HCG day were higher in the pregnant patients than the non-pregnant patient,the difference was significant(P<0.05).Conclusion:In the process of COS,the serum level of INH-B have obvious:the serum levels of INH-B reduce after pituitary down-regulation,then increased after COS.Basal serum levels of INH-B was negatively correlated with the amount of Gn in PCOS group.BMI and basel serum INH-B levels were negatively correlated in the tow groups.ΔINH-B is imformative about the dosage of Gn duration of COS and the number of oocytes retrieved.In the control group of patiens with nenstrual regularity,the change of serum INH-B level during the course of COS was a perdictor of the pregnancy occurs. Serum and follicular INH-B levels can not predict the outcome of pregnancy in patients with PCOS.