Effect Of Body Mass Index And Basal Testosterone Level On Outcome Of IVF-ET In Patients With Polycystic Ovary Syndrome

Objective:In this retrospective study,the destination is to figure out the effects of body mass index(BMI)and basal testosterone level on outcome of in vitro fertilization and embryo transfer(IVF-ET)with long-acting gonadotropin-releasing hormone agonist protocle in polycystic ovary syndrome(PCOS).Methods:In the retrospective study performed in the Center of reproductive medicine,the Second Hospital of Hebei Medical University,we indexed our patients who underwent IVF using the conventional prolonged protocol of GnRH-agonist from January 2012 to January 2018.Patients were divided into four groups according to BMI and basal testosterone level:overweight-hyperandrogenism(HA)group,n=336,overweight-non-HA group,n=439,non-overweight-HA group,n=307,and non-overweight-non-HA group,n=376.Results:A significantly higher number of oocytes and available embryos were retrieved,the embryo transfer cancellation rate was higher and the total Gn consumption was significantly lower,in the non-overweight groups than in the overweight groups.For overweight group the total Gn dosage was lower,in the HA groups than in the non-HA group but there was no statistically significant difference.Gn stimulation days was significantly shorter in the HA groups than in the non-HA group.The estradiol level and progesterone level on human chorionic gonadotropin day were significantly higher in the HA groups than in the non-HA group.The luteinizing hormone level on human chorionic gonadotropin day was higher in the HA groups than in the non-HA group,but there was no statistically significant difference.A higher number of oocytes and available embryos were retrieved and the embryo transfer cancellation rate was significantly higher in the HA groups than in the non-HA group.For non-overweight group,Gn consumption was shorter in the HA groups than in the non-HA group,but there was no statistically significant difference.The estradiol level on human chorionic gonadotropin day,progesterone level on human chorionic gonadotropin day,luteinizing hormone level on human chorionic gonadotropin day,the number of oocytes,available embryos and embryo transfer cancellation rate were higher in the HA groups than in the non-HA group,but there was no statistically significant difference.Clinical pregnancy rate and Live-birth rate were of no significant difference among four groups.The miscarriage rate in overweight-HA group was significantly higher than that in non-overweight-non-HA group(44.5%vs.26.9%,P<0.05).Multivariate logistic regression analysis revealed that BMI and basal testosterone level both acted as significantly influent factors on miscarriage rate.The area under the curve(AUC)in receiver operating characteristic(ROC)analysis for BMI and basal testosterone level on miscarriage rate were 0.608(P=0.006)and 0.578(P=0.000),respectively,and the cut-off values of BMI and basal T were 24.35 kg/m~2 and 0.535ng/mL,respectively.Conclusions:In IVF cycles with Ultra-long protocol,economic benefits were seen in non-overweight patients with PCOS,with less Gn cost and more retrieved oocytes.More retrieved oocytes and higher embryo transfer cancellation rate were seen in HA patients with PCOS.BMI and basal testosterone level were both significantly influential factors with some predictive ability on the miscarriage rate.The predictive value of BMI on miscarriage was slightly stronger than basal testosterone level.