Effects of Basal LH and Different LH/FSH Ratio Levels on Assisted Reproduc-tive Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome
Objective:To investigate the effects of basal luteinizing hormone(bLH)and different luteinizing hor-mone/follicle stimulating hormone ratio(LH/FSH)on the pregnancy outcome of in vitro fertilization or intracyto-plasmic sperm injection(IVF/ICSI)in patients with polycystic ovary syndrome(PCOS).Methods:From July 2013 to January 2020,424 PCOS patients who underwent flexible gonadotropin-releasing hormone antagonist protocol for ovulation induction in first IVF/ICSI were collected retrospectively from the department of reproductive medi-cine,The First Affiliated Hospital of Nanjing Medical University.The patients were divided into normal bLH(LH≤10 U/L,316 cases)and high bLH(LH>10 U/L,108 cases)group according to different levels of bLH;At the same time,according to the different levels of LH/FSH ratio,they were divided into low ratio(LH/FSH≤1,227 cases)group,median ratio(1<LH/FSH<2,142 cases)group and high ratio(LH/FSH≥2,55 cases)group.The general condition,ovulation induction and pregnancy outcomes of the groups were analyzed and compared Binary Logistic regression was used to analyze the related factors affecting live birth.Results:①The basal FSH and AMH in high bLH group were higher than those in normal bLH group,and the difference was statistically significant(P<0.05).In terms of ovarian induction,the number of oocytes retrieved and endometrial thickness on HCG injection day in the high bLH group were smaller than those in the normal bLH group,but the total duration of antagonist used was longer and the differences were statistically significant(P<0.05).Furthermore the pregnancy outcomes of the two groups had no statistical difference(P>0.05).②Compared with patients in different LH/FSH ratio groups,the high ratio group had higher AMH and antral follicle count(AFC)than the other two groups,and the differences were statistically significant(P<0.05).In terms of ovulation induction,the high ratio group had lower numbers of retrieved eggs,transferred embryos,and endometrial thickness on HCG day compared to the other two groups,with statistically significant differences(P<0.05).There was no statistically significant difference in pregnancy outcome indicators among the three groups of patients(P>0.05).③Binary Logistic regression analy-sis showed no significant correlation between live birth rate and bLH,LH/FSH ratio(P>0.05),but the live birth rate was related to the number of embryos transferred(P<0.05).Conclusions:Elevated bLH level and LH/FSH ratio may affect the outcomes of ovulation induction in women with PCOS(such as the number of oocytes re-trieved and endometrial thickness on HCG injection day),but there is no significant correlation with live birth rate of assisted reproduction.
万方数据
维普
