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| Predictive value of homeostasis model assessment insulin resistance on pregnancy outcome in infertility patients with PCOS undergoing IVF-ET |
| HU Yueyue1 ZHANG Changjun1,2,3 |
1.Reproductive Medicine Center, the People′s Hospital of Hubei University of Medicine, Hubei Province, Shiyan 442000, China;
2.Biomedical Engineering College, Hubei University of Medicine, Hubei Province, Shiyan 442000, China;
3.Embryonic Stem Cells of Hubei Key Laboratory, Hubei University of Medicine, Hubei Province, Shiyan 442000, China |
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Abstract Objective To investigate the predictive value of homeostasis model assessment insulin resistance (HOMA-IR) on the pregnancy outcome in infertility patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods The clinical data of 86 patients with PCOS treated with IVF-ET from August 2014 to August 2016 at the Reproductive Medicine Center of People′s Hospital of Hubei Medical College were analyzed retrospectively. According to HOMA-IR, those patients were divided into two groups including the observation group (insulin Resistant group, HOMA-IR≥1.66, n = 44) and control group (non-insulin resistance group, HOMA-IR <1.66, n = 42). The general situation, controlled ovarian hyperstimulation, pregnancy outcome and complications were compared in the two groups. Logistic regression analysis was performed on the factors influencing the outcome of IVF-ET in patients with PCOS. Results The levels of BMI, FTI, Glu, INS and HOMA-IR in the observation group were significantly higher than those in the control group (P < 0.01), and the number of oocytes retrieved, the clinical pregnancy rate and live birth rate was significantly lower in the observation group (P ＜ 0.05). There was no significant difference in the normal fertilization rate, high quality embryo rate, embryo implantation rate, OHSS incidence, and early abortion rate between the two groups (P ＞ 0.05). The BMI, age and infertility duration were risk factors on pregnancy outcome of patients with PCOS undergoing IVF-ET (P ＜ 0.05), however AMH was protective factor (P ＜ 0.05). Conclusion The lower HOMA-IR value may be a better predictor for a better pregnancy outcome in patients with PCOS undergoing IVF-ET.
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[1] Gurnell E，Chans dee VK． Dehydroepiandrosterone replacement therapy [J]. Eur J Endocrinol，2001，145（1)：103-106.
[2] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome [J]. Fertil Steril，2004，81（1）：19-25.
[3] Diamanti-Kandarakis E，Baillargeon JP，Lumo MJ，et al. A modern medical quandary：polycystic ovary syndrome，insulin resistance，and oral contraceptive pills [J]. J Clin Endocrinol Metab，2003，88（5)：1927-1931.
[4] Ovalle F，Azziz R. Insulin resistance，polycystic ovary syndrome，and type 2 diabetes mellitus [J]. Fertil Steril，2002， 77（6）：1095-1105.
[5] Hai-Yan Y，Yan M，Xin-Hong L，et al. The correlation of plasma omentin-1 with insulin resistance in non-obese polycystic ovary syndrome [J]. Annales Dendocrinologie，2015，76（5）：620-627.
[6] 董智力，韩世愈，李岩，等.游离睾酮指数与伴高雄激素血症的多囊卵巢综合征的相关性研究[J].哈尔滨医科大学学报，2012，46（2）：144-146.
[7] 程晓宇，刘秀春.体质量对多囊卵巢综合征患者激素水平和糖脂代谢的影响研究[J].黑龙江医学，2017，41（5）：412-414.
[8] 曹云霞，唐静文.多囊卵巢综合征患者胰岛素抵抗和高胰岛素血症的诊治[J].中国实用妇科与产科杂志，2013， 29（11）：864-866.
[9] 林秀峰，吴日然，杜静，等．游离睾酮指数对诊断多囊卵巢综合征高雄激素血症不孕患者的价值[J].中山大学学报：医学科学版，2010，31（3）：391-396.
[10] 李岩，王国纬，梁琛，等.游离睾酮指数对诊断多囊卵巢综合征的临床研究[J].山西医药杂志，2017，46（9）：1051-1053.
[11] Mioni R，Chiarelli S，Xamin N，et al. Evidence for the presence of glucose transporter 4 in the endometrium and its regulation in polycystic ovary syndrome patients [J]. J Clin Endocrinol Metab，2004，89（8）：4089-4096.
[12] 王辉，张治芬.囊卵巢综合征异常的内分泌激素改变对子宫内膜的影响[J].生殖医学杂志，2013，22（6）：458-462.
[13] Ciaraldi TP. Molecular Mechanisms of Insulin Resistance in the Polycystic Ovary Syndrome [M]//Androgen Excess Disorders in Women. Humana Press，2006：15-20.
[14] Carvajal R，Rosas C，Kohan K，et al. Metformin augments the levels of molecules that regulate the expression of the insulindependent glucose transporter GLUT4 in the endometria of hyperinsulinemic PCOS patients [J]. Hum Reprod，2013，28（8)：2235-2244.
[15] 关志宝.多囊卵巢综合征患者性激素水平与胰岛素抵抗关系研究[J].中国医师杂志，2005，7（3）：417-418.
[16] 王雪，张翠莲，张少娣，等.体质量指数对多囊卵巢综合征患者移植优质胚胎后早期妊娠丢失的影响[J].实用妇产科杂志，2016，32（3）：220-224.
[17] Pinola P，Morin-papunen LC，Bloigu A，et al. Anti-Müllerian hormone：correlation with testosterone and oligo-or amenorrhoea in female adolescence in a population-based cohort study [J]. Hum Reprod，2014，29（10）：2317-2325.
[18] Elgindy EA，El-Haieg DO，El-Sebaey A. Anti-Müllerian hormone：correlation of early follicular，ovulatory and midluteal levels with ovarian response and cycle outcome in intracytoplasmic sperm injection patients [J]. Fertil Steril，2008，89（6）：1670-1676.
[19] Koninger A，Sauter L，Edimiris P，et al. Predictive markers for the FSH sensitivity of women with polycystic ovary syndrome [J]. Hum Reprod，2014，29（3）：518-524.
[20] 程萍，张丽萍，刘永珍.抗苗勒激素对体外受精-胚胎移植结局的预测作用[J].湖北医药学院学报，2012，31（1）：7-10. |
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