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Objective To evaluate the effect of serum LH level on the day of superovulation start on the prolonged gonadotropin-releasing hormone ngonist therapy on the outcomes of in vitro fertilization and embryo transfer (IVF-ET) in patents with ovarian endometriomas. Methods 75 patients with ovarian en-dometriomas were treated by laparoscopic cystectomy or laparotomy cystectomy or ultrasound-mediated cysts puncture, and gonadotropin-releasing hormone agonist (GnRH-α) was given for 3 to 4 times every 28 days after the operation. Superovulation started after 14 ～ 84 days of the last injection. All the patients were di-vided into two groups according to the level of serum LH. Group A included 30 patients whose level of LH was less than 0. 5IU/L, and group B included 45 patients whose level of LH was over 0.5IU/L and less than 1.5IU/L. The outcomes of IVF-ET were evaluated. Results The total ampoules of Gn administration and the ampoules of hMG needed in group A[(32.28±7.7) ampoules, ( 12.0±8. 9) ampoules,]were sig-nificantly more than that in group B[( 25.84±7. 1 ) ampoules, ( 6. 19±7.4) ampoules, P < 0.05] . The successful embryo implantation rate in group A( 18. 1% ) was lower than group B(26. 7% ), and the differ-ence has statistical significance ( P <0. 05). Conclusion The low level of serum LH on the superovula-lion day on the prolonged gonadotropin-releasing hormone agonist protocol will increase the ampoules of Gn administration and decrease the successful embryo implantation rate of IVF-ET, thus LH should be a more important reference parameter of superovulation start.
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Objective To evaluate the decreased level of serum inhibin B(INHB)treated by gunadotropin releasing hormone agonist(GNRH-a)in predicting ovarian response and pregnancy in in vitro fertilization-embryo transfer(IVF-ET).Methods The prospective study enrolled 124 women given by GnRH-a+recombine follicle stimulating hormone(rFSH)+human chorionic gonadotrophin(hCG)long term stimulation protocol undergone their first cycle of IVF-ET treatment.The following predictive factors were collected and analyzed,such as age,basal level of follicle stimulating hormone(FSH),the ratio of FSH/luteinizing hormone(LH),the concentration of INHB after down-regulation,total number of antral follicle count(AFC)and mean ovarian volume. Ovarian response was evaluated by the number of oecytes obtained.A multiple regression analysis and logistic regression model were used for all possible prognostic variables to evaluate the value of difierent hormones in predicting ovariall response and pregnancy after IVF-ET.Receiver operating characteristic(ROC) analysis was used to evaluate the level of INHB in predicting the number of oocytes obtained.The sensitivity and specificity were calculated at the discriminating cut-off point Results The concentration of INHB after down-regulation showed a highly significant positive correlations with the number of oocytes obtained(r=0.435,P<0.01).The multiple regression analyses showed INHB was the most significant predictor of the number of retrieved oocytes,but INHB was not associated with IVF-ET outcome significantly(P>0.05).ROC analyses showed INHB after down-regulation had the largest area under curve(AUC)0.933(95%CI:0.878-0.988).When a threshold of 15 ng/L of INHB was established,95.5%sensitivity and 50.0% specificity in ovarian response were observed.Conclusions The level of INHB Was the best factor in predicting ovarian response in IVF-ET.Decreased level of INHB Was the early sign of ovarian reserve function failure,however,useless in predicting IVF-ET outcome.
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n occurring after the treatment of IVM in women with PCOS are not mounting. However, the relative high rates of multiple pregnancies, low birth weight and preterm labor were increased.
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Objective To explore the prevalence of nonalcoholic fatty liver disease(NAFLD)in patients with polycystic ovary syndrome(PCOS).MethodsA case-control study employing 60 non pregnant patients with PCOS and 60 non-pregnant patients without PCOS as control was conducted to compare the prevalence of NAFLD.Resuits The aminotransferase(ALT),fasting insulin and homeostasis model assessment of insulin resistance(HOMA-IR)levels were(29±15)U/L,(19±12)mU/L and 0.47±0.29 in PCOS group,which were significantly higher(P＜0.05)than corresponding parameters in control group[(15±13)U/L,(11±8)mU/L and 0.31±0.21)].The occurrence of insulin resistance and NAFLD was 63％(38/60)and 42％(25/60),higher than those in control group[35％(21/60)and 20％(12/60),P＜0.05].The increment of ALT was 40％(24/60)in PCOS group,higher than that of 3％(2/60)in control group(P＜0.01).Compared with patients witIlout NAFLD,patients with NAFLD had significantly increased body mass index(P＜0.01),waist-hip ratio,AIJT,C-reaction protein,fasting insulin,insulin and HOMA-IR levels 2 hours after oral glucose tolerance test(P＜0.05).Conchsion The increased prevalence of NAFLD in PCOS patients suggests an association between these two conditions and the necessity of hepatic screening among PCOS patients for potential NAFLD.