RESUMEN
Objective: To explore the effects of hyperandrogenism (HA) on pregnancy outcomes in women with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods: A retrospective study was conducted on infertile women with PCOS undergoing IVF/ICSI-ET from January 2017 to June 2021 in our center. Patients were divided into HA group and NON-HA group according to the levels of testosterone. Propensity score matching (PSM) was used to balance the influence of female age and IVF/ICSI-ET for patients with gonadotropin-releasing hormone (GnRH)antagonist protocol and GnRH agonist protocol, separately. After the PSM procedure, 191 cases in HA group and 382 cases in NON-HA group, were included. Hormone levels and pregnancy outcomes were compared in the two groups. Results: The female age was comparable in two groups [HA: (29.6±3.7) vs NON-HA: (29.5±3.6), P=0.665]. The basal luteinizing hormone [(10.82±6.73) vs (7.76±5.30) IU/L], testosterone [(3.27±0.97) vs (1.60±0.59) nmol/L], free androgen index (7.13 vs 2.77), anti-mullerian hormone [(11.37±5.74) vs (9.67±4.67) ng/ml], fasting glucose [(5.18±0.49) vs (5.06±0.42) mmol/L], 1h glucose [(9.34±2.42) vs (7.99±2.21) nmol/L], 2 h glucose [(7.66±2.17) vs (6.64±1.84) nmol/L], 2 h insulin [(129.81±145.49) vs (97.51±86.92) mU/L], total cholesterol [(5.35±0.89) vs (4.92±0.92) mmol/L], triglycerides [(1.55±1.28) vs (1.33±0.77) mmol/L], and low density lipoprotein cholesterol levels [(3.38±0.66) vs (3.14±0.71) mmol/L] were significantly higher in HA group, compared with NON-HA group (P<0.05). The initiated gonadotropin dose was higher in HA group than that in NON-HA group [(126.96±33.65) vs (137.60±38.12) U, P=0.001], but moderate-severe ovarian hyperstimulation syndrome (OHSS) rate was similar in two groups (P>0.05). The rates of implantation, clinical pregnancy, miscarriage, and live birth were comparable between the two groups (P>0.05). Also, in the subgroups, the rates of implantation, clinical pregnancy, live birth, and miscarriage were similar in HA group and NON-HA group. Conclusions: The risks of hormonal abnormality and glucose-lipid metabolic disorder were higher in PCOS women with HA, whereas satisfactory pregnancy outcomes could be achieved under proper ovarian stimulation undergoing IVF/ICSI-ET.
Asunto(s)
Aborto Espontáneo , Hiperandrogenismo , Infertilidad Femenina , Síndrome del Ovario Poliquístico , Embarazo , Femenino , Humanos , Masculino , Inyecciones de Esperma Intracitoplasmáticas , Resultado del Embarazo , Estudios Retrospectivos , Infertilidad Femenina/terapia , Índice de Embarazo , Semen , Fertilización In Vitro/métodos , Transferencia de Embrión , Inducción de la Ovulación/métodos , Hormona Liberadora de Gonadotropina , TestosteronaRESUMEN
The oxidation of hydrogen bromide and alkali metal bromide salts to bromine in acetic acid by cobalt(III) acetate has been studied. The oxidation is inhibited by Mn(OAc)(2) and Co(OAc)(2), which lower the bromide concentration through complexation. Stability constants for Co(II)Br(n)() were redetermined in acetic acid containing 0.1% water as a function of temperature. This amount of water lowers the stability constant values as compared to glacial acetic acid. Mn(II)Br(n)() complexes were identified by UV-visible spectroscopy, and the stability constants for Mn(II)Br(n)() were determined by electrochemical methods. The kinetics of HBr oxidation shows that there is a new pathway in the presence of M(II)Br(n)(). Analysis of the concentration dependences shows that CoBr(2) and MnBr(2) are the principal and perhaps sole forms of the divalent metals that react with Co(III) and Mn(III). The interpretation of these data is in terms of this step (M, N = Mn or Co): M(OAc)(3) + N(II)Br(2) + HOAc --> M(OAc)(2) + N(III)Br(2)OAc. The second-order rate constants (L mol(-)(1) s(-)(1)) for different M, N pairs in glacial acetic acid are 4.8 (Co, Co at 40 degrees C), 0.96 (Mn, Co at 20 degrees C), 0.15 (Mn(III).Co(II), Co at 20 degrees C), and 0.07 (Mn, Mn at 20 degrees C). Following that, reductive elimination of the dibromide radical is proposed to occur: N(III)Br(2)OAc + HOAc --> N(OAc)(2) + HBr(2)(*). This finding implicates the dibromide radical as a key intermediate in this chemistry, and indeed in the cobalt-bromide catalyzed autoxidation of methylarenes, for which some form of zerovalent bromine has been identified. The selectivity for CoBr(2) and MnBr(2) is consistent with a pathway that forms this radical rather than bromine atoms which are at a considerably higher Gibbs energy. Mn(OAc)(3) oxidizes PhCH(2)Br, k = 1.3 L mol(-)(1) s(-)(1) at 50.0 degrees C in HOAc.
RESUMEN
The reaction of cobalt(III) acetate with excess manganese(II) acetate in acetic acid occurs in two stages, since the two forms Co(IIIc) and Co(IIIs) are not rapidly equilibrated and thus react independently. The rate constants at 24.5 degrees C are kc = 37.1 +/- 0.6 L mol-1 s-1 and ks = 6.8 +/- 0.2 L mol-1 s-1 at 24.5 degrees C in glacial acetic acid. The Mn(III) produced forms a dinuclear complex with the excess of Mn(II). This was studied independently and is characterized by the rate constant (3.43 +/- 0.01) x 10(2) L mol-1 s-1 at 24.5 degrees C. A similar interaction between Mn(III) and Co(II) is substantially slower, with k = (3.73 +/- 0.05) x 10(-1) L mol-1 s-1 at 24.5 degrees C. Mn(II) is also oxidized by Ce(IV), according to the rate law -d[Ce(IV)]/dt = k[Mn(II)]2[Ce(IV)], where k = (6.0 +/- 0.2) x 10(4) L2 mol-2 s-1. The reaction between Mn(II) and HBr2., believed to be involved in the mechanism by which Mn(III) oxidizes HBr, was studied by laser photolysis; the rate constant is (1.48 +/- 0.04) x 10(8) L mol-1 s-1 at approximately 23 degrees C in HOAc. Oxidation of Co(II) by HBr2. has the rate constant (3.0 +/- 0.1) x 10(7) L mol-1 s-1. The oxidation of HBr by Mn(III) is second order with respect to [HBr]; k = (4.10 +/- 0.08) x 10(5) L2 mol-2 s-1 at 4.5 degrees C in 10% aqueous HOAc. Similar reactions with alkali metal bromides were studied; their rate constants are 17-23 times smaller. This noncomplementary reaction is believed to follow that rate law so that HBr2. and not Br. (higher in Gibbs energy by 0.3 V) can serve as the intermediate. The analysis of the reaction steps then requires that the oxidation of HBr2. to Br2 by Mn(III) be diffusion controlled, which is consistent with the driving force and seemingly minor reorganization.