Effect Of Initial Index On Embryonic Development And Pregnancy Outcome In Patients With Diminished Ovarian Reserve

Objective:For infertile female patients with diminished ovarian reserve,analyze the initial indicators that may affect ovarian reserve function(such as age,body mass index,basal follicle stimulating hormone levels,anti-Mullerian hormone,antral follicle count,etc.)and the effects of different ovulation promoting programs on embryogenesis and development and the progesternal outcomes during the IVF-ET process.Methods:A retrospective analysis of 234 cycles of 25-47 years old female patients with diminished ovarian reserve receiving IVF-ET treatment was performed.The age was divided into two groups:age≤35 years old,age>35 years old,BMI was divided into two groups:BMI<24kg/m~2,BMI≥24kg/m~2,the basic FSH is divided into two groups:b-FSH<10 IU/L,b-FSH≥10 IU/L,the b-FSH/b-LH is divided into two groups:b-FSH/b-LH<2,b-FSH/b-LH≥2,AMH is divided into two groups:AMH<1.1ng/ml,AMH≥1.1ng/ml,AFC is divided into two groups:AFC<7,AFC≥7,and the ovulation promotion protocol is divided into two groups:GnRH antagonist program and micro-stimulation program.A multivariate analysis was performed to determine the effects of age,BMI,b-FSH,b-FSH/b-LH,AMH,AFC and ovulation promotion protocol on embryonic development and pregnancy outcome.Result:The results showed that factors associated with the total Gn doses and the total Gn days were BMI,AFC and the ovulation promotion protocol.Factors related to fertilization rate were age,b-FSH,b-FSH/b-LH and AFC.Factors related to the MII rate were b-FSH,b-FSH/b-LH and AFC.The factor associated with ovum utilization rate was age.The factor associated with cleavage rate was BMI,and the factor associated with blastocyst formation rate was b-FSH/b-LH;factors associated with the number of transplantable embryos were b-FSH,AMH and ovulation promotion protocol,and the factor associated with the cycle cancellation rate was b-FSH,the factor associated with biochemical pregnancy was b-FSH/b-LH,and no factor was associated with clinical pregnancy.Conclusion:In the initial indicators,age was only related to ovum quality,AMH was only related to the number of transplantable embryos,BMI was related to Gn usage and embryo quality,AFC was related to Gn usage and ovum quality,b-FSH and b-FSH/b-LH were related to ovum quality,embryo quality and clinical outcomes.The ovulation promotion protocol was related to Gn usage and the number of transplantable embryos.In the future development of ART,we should invest more attention and researches on b-FSH and b-FSH/b-LH in order to get better ART outcomes.