Analysis Of The Effect Of Integrin αvβ3 On Embryo Quality And Pregnancy Outcome In IVF Patients With Polycystic Ovary Syndrome

Objective:Embryo quality deteriorated in patients with polycystic ovary syndrome under assisted reproductive technology, the endocrine hormone changes of PCOS may resulted in the oocyte growth microenvironment changed. This study used correlation analysis between the level of integrin αvβ3 in the follicular fluid and other indicators, in order to find the possible factors that affecting embryo quality in patients with polycystic ovary syndrome,. For further improve the pregnancy outcome in patients with polycystic ovary syndrome provide theoretical and experimental basis.Methods:1. The predictive value of the level of integrin αvβ3 in the follicular fluid for pregnancy outcome of IVF/ICSI-ET in patients with PCOSChoose cases of undergoing IVF/ICSI-ET treatment of patients with PCOS due to the man semen factor or woman tubal factors as experimental group, choose simple for man semen factor or woman tubal factors IVF/ICSI-ET cases as control group, collect the serum hormone level testing values, long protocol controlled ovarian hyperstimulation (COH), collecting follicular fluid samples from patients after oocyte retrieval, use ELISA to determine the level of integrin αvβ3, further analysis expression level of integrin αvβ3 between IVF/ICSI outcomes including the number of eggs, rate of oocytes maturation and fertilization rate, implantation rate, good quality embryo rate and the biological/clinical pregnancy rate.2. The related factors affect the embryo quality of patients with PCOSChoose clinical cases data of infertile women from June 2009 to December 2015 in reproductive medicine center for IVF/ICSI-ET, comparing embryo quality and pregnancy outcome of fresh cycle transplantation of patients with and without PCOS, and embryo quality related indexes were analyzed.Results:1. The relationship between the protein expression of integrin αvβ3 in follicular fluid and the quality of embryos in PCOS patients.1.1 The protein expression level of integrin αvβ3 in follicular fluid and antral follicle count (r= 0.701, P= 0.701), MII egg number (r= 0.763, P= 0.017), and high quality embryo number (r= 0.273, P= 0.041) were positively correlated in patients with PCOS.2 Correlation between the protein expression of integrin αvβ3 in follicular fluid and the outcome of pregnancy.2.1 When the protein expression of integrin αvβ3 in follicular fluid> 63.0125 ug/ml, the sensitivity and specificity for predicting pregnancy was 0.615 and 0.708.2.2 The implantation rate, pregnancy rate, cumulative pregnancy rate, accumulated live-birth rate of high expression integrin αvβ3 group is significantly higher than the low expression group (P< 0.05), the difference was statistically significant (P< 0.05).3 Analysis of other related factors affecting the quality of embryo and pregnancy outcome in patients with PCOS.3.1 The number of collected eggs PCOS group more than the non-PCOS group, but the normal fertilization rate and good quality embryo rate of the non-PCOS group were higher than PCOS group, compared the two groups have statistical difference (P<0.05). The probability of OHSS occurred PCOS group was obviously higher than the non-PCOS group(P<0.05).3.2 In PCOS group when BMI<24 kg/m2 the cleavage rate and the good quality embryo rate of were higher than BMI>24 kg/m2, and when T≥2.44 nmol/L, eggs mature rate is lower than T< 2.44 nmol/L group, the difference was statistically significant (P<0.05). In non-PCOS group comparison between different levels of body mass index (BMI) and testosterone levels had no obvious different.Conclusions:1. Integrin αvβ3 level in follicular fluid was associated with the number of oocyte maturation and high quality embryo.2. The protein expression of integrin αvβ3 in follicular fluid may related to the implantation rate, pregnancy rate, cumulative pregnancy rate, accumulated live-birth rate of PCOS patients. The protein expression of integrin αvβ3≥ 63.0125 ug/ml can be used as predicting reference of clinical pregnancy.3. Normal fertilization rate and good quality embryo rate in patients with polycystic ovary syndrome was lower than normal people, but OHSS rate was higher than normal people. High BMI may affect the cleavage rate and the high quality rate of embryos, and high testosterone levels may affect the rate of oocyte maturation.