Changes Of Serum C-reactive Protein Level In IVF/ICSI-ET And Prediction Of Pregnancy Outcome

Objective:The purpose of this study was to investigate the changes of serum C-reactive protein level during in vitro fertilization?IVF?/intracytoplasmic sperm injection?ICSI?,in order to provide a theoretical basis for predicting and providing further directions of pregnancy outcomes in IVF/ICSI-ET patients.Methods:Regression analysis was performed on infertile patients undergone IVF/ICSI-ET in Reproductive Medicine Department of the Second Hospital of Hebei Medical University from November 2019 to January 2020and 111 COS cycles were met the inclusion criteria.The serum CRP values were measured on the day of Gn initiation,the day of triggering the day of ovum pick-up?OPU?,and the day of embryo transfer.Patients were divided into pregnancy group?n=41?and non pregnancy group?n=32?according to whether pregnancy was obtained after 14 days after transplantation.The clinical data,serum CRP values and the change ratio of serum CRP were compared between two groups.Results:BMI and infertility years were correlated with serum basal CRP levels?P₁=0.002?P₂=0.030?.After linear regression analysis,only BMI was included in the regression equation,regression coefficient was 0.076?95%CI0.008-0.145,P=0.029?.There was no significant differences in serum CRP levels between different infertility types and different controlled ovarian hyperstimulation.During IVF/ICSI,the serum CRP value on the day of Gn initiation was lower than that of h CG,the serum CRP value on the h CG day was lower than the OPU day,and the serum CRP value on OPU day was lower than the transfer day?1.941±0.899 vs 2.830±2.218 vs 3.391±2.092 vs4.883±2.527 P<0.001?.Multivariate logistic regression showed that the ratio of serum CRP value between transfer day and h CG day was an independent risk factor for pregnancy outcome?OR=0.384,95%CI:0.179-0.828,P=0.015?.The ROC curve was drawn according to the logistic regression model.The area under the curve had an AUC of 0.681?95%CI:0.542-0.821?,a cut off value of 1.763,a Jordan index of 0.391,a sensitivity of 61.3%,and a specificity of 77.8%.Conclusions:1.There was a correlation between serum CRP levels and patients BMI levels.Increasing BMI values can lead to serum CRP levels elevation.2.COH was a process of systemic inflammatory response.The inflammatory response was strengthened after the trigger,Further rise after ovum pick-up.3.The ratio of serum CRP value between transfer day and h CG day was less than 1.763 and can be used as an indicator to predict the pregnancy outcome after IVF/ICSI treatment,with a sensitivity of 61.3% and a specificity of 77.8%.