The Analysis Of Predictive Factors Of High Ovarian Response And Its Influence On The Outcome Of IVF/ICSI-ET In The Non-PCOS Patients

Objective: To select predictors of high ovarian response in non-PCOS patients,andto assist doctors making more reasonable super ovulation programs so as to reduce theside effects of COH and improve the pregnancy rate of single birth in clinical work.Methods: A retrospective analysis of1170patients who received IVF/ICSItreatment by the way of conventional long program from January2011to December2011in our hospital.Patients whose E2was higher than the75th percentile(E2≥3903ng/ml) and whose oocytes’number was more than15were classified to highovarian response group.Patients whose E2value was between25percentile to75percentile (E2:1479-3903ng/ml) and whose oocytes’number was less than15wereclassified to normal ovarian response group.Totally213patients were enrolled in to ourstudy,in which there were114cases in high ovarian reactive group and99cases innormal ovarian reaction group.We detected the number of antral follicles (AFC) of thenatural cycle, body mass index (BMI), the basis of endocrine (E2, LH, FSH, LH/FSH,T), E2, LH, FSH after the treatment and reducing amplitude of each hormone after thetreatment and other indicators.Using logistic regression analysis and ROC curve fordata management and analysis.Results: Compared to normal ovarian response group,high ovarian response grouphad a higher AFC (P≤0.05), T (P≤0.05), reducing amplitude of E2(P≤0.05) and E2after the treatment (P≤0.05). Logistic Stepwise regression analysis showed that theindependent risk factors for high ovarian response contain AFC (OR=1.194; P=0.002), T (OR=50.922;P=0.005), E2after the treatment (OR=1.069; P=0.004).prediction performance descending order is that:T (b′=0.680), AFC (b′=0.658),after falling tone E2(b′=0.576). ROC curve analysis shows the cut-off point of AFC, Tand E2after the treatment were:10.5pieces0.2995ng/ml15.355ng/ml. Compared with normal ovarian response group, ovarian high responsive patients, the number of oocytes(P≤0.05), the number of fertilized eggs (P≤0.05), implantation rate (P≤0.05) andmultiple pregnancy rate (P≤0.05) were significantly increased,and leading to anincreased incidence of severe OHSS.Conclusion: non-PCOS infertility patients with AFC≥11pieces, T≥0.2995ng/ml, and E2≥15.355ng/ml after the treatment had a high incidence of high ovarianresponse.The components in descending order effecting the high Ovarian reaction wereT> AFC>E2.High ovarian response could increase the implantation rate as well asincrease the risk of multiple pregnancies.Besides,it could lead to a higher incidence ofsevere OHSS, so it was recommended that patients with ovarian high response shouldreceive selective single embryo blastocyst transfer.