Application Of Follicular Output Rate In Predicting The Outcome Of IVF/ICSI Assisted Pregnancy In Patients With PCOS

Objective:PCOS is the most common cause of anovulation infertility in women of reproductive age.Most of PCOS infertility patients are able to conceive smoothly after regular outpatient ovulatory stimulation and artificial insemination treatment.But some patients who have been ovulated,artificial insemination still can not help pregnancy,need to use IVF/ICSI technique to fertility treatments,this part of patients often after a long fertility treatments,spent a lot of money and time.And the long-term fertility treatments also makes the patient body and mind exhausted.The purpose of this study was to study the practical clinical application value of FORT in predicting the outcome of IVF/ICSI assisted pregnancy in PCOS patients,in order to find a better index to predict the outcome of IVF/ICSI assisted pregnancy in PCOS patients,and to facilitate clinicians to formulate individualized COH regimen.To minimize iatrogenic effects,reduce patient costs and the psychological burden of patients.Methods:PCOS patients aged 21-35 years who underwent assisted pregnancy therapy from January 2016 to October 2017 in the first affiliated Hospital of Nanchang University were selected as the study subjects.The venous blood from 2-3 days of natural menstruation was extracted from 5 ml in 1-3 months before the treatment cycle.The supernatant was centrifuged in 3000rpm/min centrifuge for 10 minutes and placed in the refrigerator at-80 ℃.After all the samples were collected,the basic hormones and AMH in blood were detected by ELISA method,and the data were collected and spearman correlation analysis was used to analyze follicular output rate and high quality embryo rate with infertility years,body mass index,age,basic sex hormone,duration of Gn,the dose of Gn,the numbers of retrieved oocytes,the fertilization rate of 2PN.ninety-one patients with PCOS underwent fresh transplantation were divided into pregnancy group non-pregnancy group according towhether they were pregnant or not.The difference of each index between the two groups was compared,and the predictive effect of each index on pregnancy outcome was evaluated by the area under the ROC curve.SPSS 17.0.Results1.A total of 153 PCOS patients with IVF/ICSI were selected during the study,91 of them with PCOS underwent fresh embryo transplantation.There was no significant difference of the age,BMI,Basic sex hormone(FSH,E2,LH,T),Infertility years,AFC,AMH,the dose of Gn,the fertilization rate of 2PN and the number of embryos transferred between the pregnant group and the non-pregnant group(P > 0.05).There were significant differences with the duration of Gn,follicle output rate,PFC and High quality embryo rate between pregnancy group and non-pregnancy group(P < 0.05).2.There was a high positive correlation between the numbers of retrieved oocytes and the Follicular output rate(r=0.823,P=0.000);FORT with the fertilization rate of 2PN(r=0.353,P=0.001),High quality embryo rate(r=0.312,P=0.003)is positively correlated;There was a negative correlation between serum AMH and FORT(r=-0.465,P=0.000);however,FORT was not related to patient’s age,Basic sex hormone,BMI,the duration of Gn and the dose of Gn.3.There was a positive correlation between the High quality embryo rate and PFC(r=0.307,p=0.003),FORT(r=0.312,p=0.003),the numbers of retrieved oocytes(r=0.382,p=0.000),the fertilization rate of 2PN(r=0.208,p=0.047).The age,BMI,infertile years,Basic sex hormone,the duration of Gn,the dose of Gn,AFC and AMH of PCOS patients was no correlation with High quality embryo rate.4.The area under the ROC curve for the prediction of pregnancy outcome of several commonly used indicators: FORT ROCAUC=0.786(95%CI:0.688-0.885;P=0.000),antral follicle count ROCAUC=0.537(95%CI:0.417-0.658;P=0.541),estradiol ROCAUC=0.519(95%CI:0.398-0.640;P=0.757),AMH ROCAUC=0.512(95%CI:0.392-0.632;P=0.840),BMI ROCAUC=0.475(95%CI:0.355-0.596;P=0.683),age ROCAUC=0.535(95%CI:0.414-0.656;P=0.568),follicule-stimulating hormone ROCAUC=0.469(95%CI:0.349-0.589;P=0.609).Conclusions:1.FORT can predict the numbers of retrieved oocytes,the fertilization rate of 2PN and the rate of high quality embryos.2.FORT can be used as an independent predictor for the outcome of assisted pregnancy in infertile patients with PCOS.in predicting the outcome of assisted pregnancy,the results were superior to those of AFC,age,basal estrogen,AMH,BMI,basal FSH.