The Relationship Between Antral Follicle Count And The Quality Of Oocyte And Embryo In Women With Polycystic Ovary Syndrome

Objective Through reviewing the antral follicle count(AFC), the qualities of oocyte and embryo, pregnancy outcome in the first in-vitro fertilization and embryo transfer(IVF-ET) treatment of normal women and women with polycystic ovary syndrome(PCOS), we aim to investigate the relationship of AFC and the qualities of oocyte and embryo in PCOS women.Methods Recruiting infertile patients who visited the reproduction center of Navy General Hospital from January 2014 to July 2015. These women looked for the IVF-ET treatment for the first time. Patients who met one of the next condition were excluded:(1)who were over 35 years old, or basic follicle-stimulating hormone(FSH) ≥ 10 m IU/ml;(2) basic prolactin(PRL) > 20ng/ml;(3) who had ovary or uterine surgery;(4) who had reproductive system malformation;(5) who with other endocrine and severe systemic disease;(6) ultrasound found ovarian cyst;(7) intrauterine adhesious. After excluding patients from above condition, patients were allocated in different group with the next condition:(1) who met the 2003 Rotterdam criteria;(2) whose ovary ultrasound indexes were normal, and with regular menstrual cycles(menstrual cycle is 21 to 35 days). We totally recruited 230 patients, including 100 patients in the PCOS group and 130 patients. And we divided PCOS patients into three sub-group(P-1 sub-group, P-2sub-group and P-3 sub-group) by AFC <30, 30-59, ≥ 60. All patients were used long protocol. Recording all subjects’ basal AFC, basic condition, control hyperstimulation ovulation(COH), oocyte and embryo condition, pregnancy outcome. Comparing the qualities of oocyte and embryo in both PCOS group, control group and every sub-groups.Results(1) Comparing the basic condition in both group: PCOS group had longer menstrual cycle length, larger BMI, more basal AFC, bigger ovarian volume(OV), and higher level of basal luteinizing hormone(LH), LH / FSH, testosterone,androstenedione than those in the control group(P < 0.05). But PCOS group had lower level of FSH than that in the control group(P < 0.001).(2) Comparing the indexes of COOH in both group: PCOS group had more AFC at the begining of the use of Gonadotropin(Gn), received oocytes, mature oocytes and high-quality D3 embryo(P <0.05), but using less dose of Gn at the begining and in total(P < 0.05). The pregnancy outcome(including implantation rate, clinical pregnancy rate, ectopic pregnancy rate and early pregnancy abortion rate and ongoing pregnancy rate after transplantation) of both group were the same(P > 0.05).(3) The basic average OV, basic LH/FSH, basic T and basic ASD had statistically difference between the three sub-groups.(4) The AFC when Gn was started, the number of mature oocytes, high-quality D3 embryo had statistically difference between the three sub-groups(P<0.05). But the pregnancy outcome were the same between the three sub-groups.(5) In the PCOS group, the AFC when Gn was started, mature oocyte count and high-quality D3 embryo number were positively correlated to basic AFC.Conclusions In IVF-ET treatment, PCOS patients needed less Gn amount, and received more mature oocytes and high-quality embryo, and these indexes were more when basic AFC increased. But the mature oocytes rate, high-quality embryo rate and pregnancy outcomes were consistented in PCOS group, normal group and PCOS sub-groups. In the PCOS patients, the basic AFC had no effect on the quality of oocytes and embryo,the pregnancy outcome.