Relatied Research Of Endometriosis-associated Infertility&Effect Of Recombinant Human Luteinizing Hormone For In Vitro Fertilization-Embryo Transfer Outcome

1. Short an long-term climnical assessment of endometrioma treatment methodsObjective:To investigate the short-term and long-term recurrence rate and pregnancy rate of adjuvant treatment with gonadotropin-releasing-hormone agonist (GnRH-a) following conservative laparoscopic surgical treatment of ovarian endometriosisMethods:Patients with ovarian endometriosis undergoing conservative laparoscopic surgery in our Hospital from January2008to July2011were collected. All the patients were grouped in two groups:surgery alone group and combination group. Subsequent follow-up of the surviving patients was performed until the end of Dec2012and the recurrence rate and pregnancy rate were compared.Results:A total of195patients with ovarian endometriosis underwent conservative laparoscopic surgical treatment and finally183patients,59in surgery alone group and124in combination group, were included in the analysis. The total pregnancy rate, six-month pregnancy rate and one-year pregnancy rate were45.8%,22.0%and39.0%in surgery alone group and55.6%,9.7%and29.0%in combination group. There was significant difference between two groups in six-month pregnancy rate (P<0.05); The total recurrent rate, six-month recurrent rate and one-year recurrent rate were10.2%,5.1%nd6.8%insurgery alone group and11.3%,1.6%and6.5%in combination group. There was no significant difference between two groups in terms of total recurrent rate, six-month recurrent rate, one-year recurrent rate and five-year recurrent rate.Conclusion:GnRH-a treatment after operative laparoscopy for ovarian endometriosis does not appear to be superior to expectant in terms of prevention of symptoms recurrence and has no significant improvement on pregnancy rate. 2. Metabolomic analysis of ovarian follicular fluids in endometriosis patientsObjective:To investigate changes of follicular fluid in patients with endometriosis using nuclear magnetic resonance (NMR) spectroscopy-based metabolite profiling.Methods:Patients receiving In vitro fertilization-Embryo transfer (IVF-ET) in our Hospital from January2008to July2011were collected and classified into8groups. Comparison between tubal pregnancy and unpregnancy; ectopic pregnancy and unpregnancy; pregnancy and unpregnancy; tubal infertility and ectopic infertility were made.follicular fluid of all patients were collected. NMR spectroscopy was performed on the fluids and the metabolic profiles were compared using principal components analysis (PCA) and partial least squares discriminant analysis (PLS-DA).Results:A total of28patients were included. More than30potential metabolites were detected to be changed between groups.Conclusion:NMR-based metabolite profiling of FF has potential for identifying changes in patients with endometriosis.3. Research on the effect of recombinant human luteinizing hormone on the clinical outcome of assisted reproductive technologyObjective:The aim of this study was to evaluate the use of luveris (recombinant luteinizing hormone, rLH) supplementation in an unselected group of in vitro fertilization-embryo transfer (IVF-T) patients after long gonadotropin releasinghormone agonist (GnRH-a) down-regulation protocol.Methods:Patients receiving IVF-ET in our Hospital from January2008to July2011were collected. All the patients were grouped in two groups:control group (rFSH alone) and combination group (rFSH combined withluveris). Subsequent follow-up of the patients was performed until the end of Dec2012. Pregnancy rate, live birth rate, high-quality embryos rate and immature embryos rate were compared.Results:A total of463patients,74in control group and124in combination group, were included in the analysis. No significant difference was found in the clinical characteristics among the2groups (P>0.05). There was no significant difference between2group in terms ofpregnancy rate and high-quality embryos rate (P>0.05). Live birth rate was much higher in combination group (54.1%) than control group (32.6%). Immature embryos rate was much higher in control group (77.5%) than combination group (73.4%). There was a significant difference in the cycle-cncellation rate and OHSS incidence between group11and other2groups(P<0.05). Time point of administration of luveris showed no influence on pregnancy rate, live birth rate, high-quality embryos rate and immature embryos rate.Conclusion:The addition of luveris to an unselected group of’down-regulated’ patients can promote the live birth rate.