The Effect Of BMI And Lipid Metabolism On Pregnancy Outcome Of PCOS Patients Undergoing IVF/ICSI Using GnRH Antagonist Protocol

Purpose: To explore the effect of body mass index(BMI)and lipid metabolism on ovarian response,embryo quality and pregnancy outcome of polycystic ovary syndrome(PCOS)patients who undergoing IVF/ICSI using Gn RH antagonist protocol.Methods: From January 2013 to June 2016,762 infertile PCOS patients,younger than 40 years old,undergoing their first IVF/ICSI oocyte retrieving cycle using Gn RH antagonist protocol were recruited to the research.The clinical date of their fresh embryo transfer cycles and frozen-thawed embryo transfer cycles were analyzed.To investigate the influence of BMI and lipid metabolism on ovarian response,embryo quality by Spearman correlation analysis.Binary Logistic regression analysis was using to investigate the influence of BMI and lipid metabolism on clinical pregnancy outcome.Results: 1.The prevalence of OHSS in the ovarian stimulation cycles is 5.8%,and the rate of severe OHSS is 2.5%.In fresh embryo transfer cycles and frozen-thawed embryo transfer cycles,the clinical pregnancy rate is respectively 61.5% and 71.4%,the abortion rate is respectively 10.7% and 10.4%,and the live birth rate is respectively 50.4% and 60.2%.2.Basic FSH negatively correlated with BMI/TG,and Basic LH negatively correlated with BMI.Basic FSH and LH level positively correlated with HDL.AMH negatively correlated with BMI/LDL.3.BMI 、TG、LDL negatively correlated with the index of ovarian response and embryo quality,while HDL positively correlated with the ovarian response and embryo quality(P <0.05).3.Logistic regression analysis showed that BMI was the risk factor of the live birth in frozen-thawed blastocyst embryo transfer cycles;HDL was the protective factor of the clinical pregnancy and the live birth in fresh embryo transfer cycles and frozen-thawed cleavage embryo transfer cycles;LDL/ TC were the risk factors of the clinical pregnancy in frozen-thawed embryo transfer cycles.Conclusions: Excessive BMI,especially BMI >28kg/m2,and abnormal lipid metabolism adversely affected PCOS patient’s ovarian response,embryo quality and clinical pregnancy outcome in Gn RH antagonist protocol.For improve the clinical pregnancy results of PCOS patients,pretreatment before IVF / ICSI will not only include weight losing,but also need attach great importance on the lipid metabolism management.In particular,re-evaluation and treatment of abnormal BMI and lipid metabolism before frozen-thawed embryo transfer could improve the cumulative pregnancy rate.