| Objective Study different body mass index(BMI)phlegmy wet pixu(spleen deficient)with polycystic ovary syndrome(PCOS)in vitro fertilization-embryo transfer(IVF-ET)sugar metabolism,androgen,promoting the process of sterility patients,fertilization,embryo formation and pregnancy outcomes,in order to understand the body mass index of clinical outcome in patients with phlegm wet PCOS pixu(spleen deficient),provide reference basis for the treatment of patients with.Methods A retrospective analysis was performed on 842 patients with polycystic ovary syndrome who underwent ivf-et assisted pregnancy in the reproductive center of anhui provincial hospital from October 2014 to October 2018.TCM dialectical classification was conducted to observe the distribution frequency and BMI distribution of major TCM syndromes of PCOS such as spleen-deficiency phlegm-dampness type,phlegm-stasis internode type,spleen-deficiency liver-stagnation type,kidney deficiency and blood stasis type.Taking spleen-deficiency phlegm-dampness type as the research object,the patients were divided into normal weight group(18.5kg/m~2 BMI<22.9kg/m~2),obese group(23kg/m~2 BMI<24.9kg/m~2),obese group(25kg/m~2 BMI<29.9kg/m~2)and severe obesity group(BMI 30kg/m~2)according to different BMI.Body mass index,age,infertility years,basic FSH,LH levels and other basic information of patients in different BMI groups were compared.And sugar metabolism,androgen status.At the same time,the E2 peak level of HCG day,the medication time of Gn,the total dosage of Gn,the number of eggs obtained and other promoting indicators were compared,as well as laboratory indicators such as2PN fertilization rate and number of high-quality embryos,as well as pregnancy results such as embryo implantation rate,clinical pregnancy rate and abortion rate.Results1?Comparison of TCM dialectical classification:among 842 patients with PCOS infertility,spleen-deficiency phlegm-dampness accounted for 47.03%(396cases),phlegm-stasis interaction type accounted for 21.14%(178cases),spleen-deficiency and liver-stagnation type accounted for 16.62%(140cases),kidney deficiency and blood-stasis type accounted for 10.57%(89cases),and other types accounted for 4.63%(39cases).It can be seen that the PCOS ratio of spleen-deficient phlegm-dampness type is the highest.According to the distribution of different syndromes and BMI in PCOS infertility patients,the patients with medium and high BMI of PCOS infertility patients with spleen deficiency and phlegm-dampness were significantly larger than those in other groups(P<0.05).2?General comparison:there were no significant differences in infertility years,age,follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels among the three groups(P>0.05).3?Comparison of glucose metabolism and androgen status:The distribution of insulin resistance and glucose tolerance in the severely obese group and the obese group was significantly higher than that in the normal BMI group,with statistically significant differences(P<0.05).The incidence of diabetes in the severe obesity group was significantly higher than that in the normal BMI group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the distribution of hyperandrogenemia and clinical manifestations among the four groups(P>0.05).4?Comparison of ovulation induction and embryo status:The total amount and time of Gn in the severe obesity and obesity group were higher than those in the other two groups,and the daily E2 peak level of HCG and the number of eggs obtained in the severe obesity and obesity group were lower than that in the normal weight group(P<0.05).The fertilization rate of 2PN and the number of high-quality embryos decreased with the increase of BMI(P<0.05).5?Comparison of clinical outcomes:There were no significant differences in embryo implantation rate and clinical pregnancy rate between different BMI groups(P>0.05),but there was a downward trend with the increase of BMI.The abortion rate of the severely obese group was higher than that of the normal BMI group(P<0.05).Conculsion1?According to the distribution of TCM syndromes,the proportion of PCOS in spleen-deficiency phlegm-dampness type is the largest.According to the different distribution of BMI of PCOS infertility patients with different syndromes,it can be seen that the patients with medium and high BMI of PCOS infertility patients with spleen deficiency and phlegm-dampness were significantly larger than those in other groups.2?The increase of BMI can improve the insulin resistance,glucose tolerance and the incidence of diabetes in PCOS patients with spleen deficiency and phlegm dampness.The increase of BMI had no significant effect on hyperandrogenemia and clinical manifestations.3?The increase of BMI can affect the ovarian response to exogenous gonadotropin stimulation in patients(<35 years old)with phan-wet polycystic ovary syndrome during IVF.The dosage and time of Gn increased with the increase of BMI,and the peak level of E2 on HCG day and the number of eggs obtained decreased with the increase of BMI.4?High BMI can affect the embryo quality of phlegm-wet type PCOS patients(<35years old)during IVF assisted pregnancy.The fertilization rate of 2PN and the number of high-quality embryos decreased with the increase of BMI.5?For the phlegm-wet type PCOS patients(<35 years old)receiving IVF,the abortion rate of women with high BMI was higher than that of women with normal BMI.There was no significant effect on the implantation rate and clinical pregnancy rate,but there was a decreasing trend. |
PDF Full Text Request