| Objective:To investigate the effects of visfatin,omentin-1 and metabolic components in follicular fluid on follicular growth,embryo development and pregnancy outcomes in in vitro fertilization and embryo transfer(IVF-ET)in patients with polycystic ovary syndrome(PCOS).Methods:130 patients undergone IVF/ICSI-ET were recruited between October 2015 and June 2016 in reproductive medicine center of the general hospital of Ningxia medical university.Either long GNRH agonist protocol or GNRH antagonist protocol was performed for all patients.The patient were divided into PCOS group and non-PCOS group according to the diagnostic criteria of Rotterdam.Obesity was determined by body mass index(BMI),obesity group: BMI ≥ 25kg/m2,normal weight group: 18.5kg/m2 < BMI < 25kg/m2.Both PCOS groups and controls were classified into two subgroups based on their BMI,so there have four groups: normal weight PCOS group;B: obese PCOS group;C: normal weight control group;D: obese control group.Anthropometric parameters,serum hormonal level(b FSH,b LH,b E2、T)、controlled ovarian hyperstimulation(COH)results and IVF outcomes were evaluated.Visfatin、omentin-1 and lipid prifile(TC、TG、HDL、LDH)in follicular fulid or serum were measured.Results:1 There was significantly diffrence between PCOS and non-PCOS in the concentration ofvisfatin and TC in follicular fuild(8.91±7.93 VS 2.38±3.01、0.76±0.16 VS 0.68±0.18,P<0.05,and the concentration of omentin-1 and HDL in follicular fuild of PCOS group were significantly lower than that of non-PCOS group(138.02±181.88 VS 524.42±469.92 、0.51±0.13 VS 0.51±0.13,P<0.05).The concentration of TG in serum of PCOS group were significantly higher than that of non-PCOS group(1.62±1.09 VS 1.21±0.61,P<0.05).2 Based on BMI1)Compared A group with B group,the level of TC,TG and LDL in serum of group A were significantly lower than group B(4.14±0.67 VS 4.78±0.97、1.21±0.72 VS 2.25±1.26、2.02±0.53 VS 2.68±0.85,P<0.05),and the level of HDL was significantly higher than group B(1.35±0..26 VS 1.01±0.30,P<0.05).2)Compared group A with group C,the level of visfatin and TC in follicular fluid were significantly higher in group A(8.25±8.17 VS 2.75±3.87、0.79±0.16 VS 0.64±0.15,P<0.05),and the level of omentin-1 and HDL were significantly lower in group A(156.49±218.21 VS424.94±476.18、0.49±0.14 VS 0.64±0.14,P<0.05).3)Compared group B with group D,and the concentration of visfatin,TG and LDL in follicular fluid of group B were significantly higher than group D(9.89±7.59 VS 1.96±1.75、0.22±0.08 VS 0.20±0.06 、 0.27±0.31 VS 2.23±0.62,P < 0.05),the concentration of omentin-1 was significantly lower than group D(101.95±60.04 VS 585.53±449.53,P<0.05),the level of TG,LDL in serum of group B were significantly higher than group D(2.25±1.26 VS 1.47±0.61、2.68±0.85 VS 2.23±0.62,P<0.05),the level of HDL was significantly lower than group D(1.01±0.30 VS 1.16±0.27,P<0.05).4)Compared group C with group D,the level of TG and LDL in follicular fluid of group C was significantly lower than that of group D(0.16±0.02 VS 0.20±0.06 、 0.08±0.09 VS2.23±0.62,P<0.05),and the level of TG in serum of group C were significantly lower than group D(0.97±0.52 VS 1.47±0.61,P<0.05),the level of HDL was significantly higher than that of group D(1.40±0.24 VS 1.16±0.27,P<0.05).There was no significant difference among other groups(P>0.05).3.The number of oocytes retrieved,MII oocytes number,fertilization eggs,cleavage,cleavage rate in PCOS group were significantly higher than that of non-PCOS group(19.16±9.97 VS 14.31±7.35 、 15.43±8.29 VS 11.45±5.80 、 12.62±6.97 VS 10.34±5.49 、12.22±6.92 VS 9.73±5.44,96.85% VS 94.07%,P<0.05).The fertilization rate in PCOS group was significantly lower than that of non-PCOS group(81.79% VS 90.28%,P < 0.05).4.The concentration of visfatin in follicular fluid of patients with PCOS showed a positive correlation with the number of oocytes retrieved(r=0.546,P<0.05)、the number of embryos(r=0.479,P<0.05).The concentration of omentin-1 in follicular fluid of patients with PCOS showed a negative correlation with BMI(r=-0.667,P<0.05)、 LDL(r=-0.498,P<0.05),and positive correlation with HDL in follicular fluid(r=0.582,P<0.05).5.The concentration of visfatin in pregnancy group was significantly higher than non-pregnant group(6.91±7.57 VS 4.75±6.11,P<0.05);The concentration of omentin-1 in pregnancy group was significantly lower than non-pregnancy group(277.98±361.75 VS406.23±448.73,P<0.05).Conclusion:1.The level of visfatin increased and omentin-1 decreased in follicular fluid of patients with PCOS irrespective of the patient’s BMI,which indicated visfatin and omentin-1 may be used as one of the indicators of PCOS.2.The concentration of visfatin in follicular fluid of patients with PCOS showed a positive correlation with the number of oocytes retrieved 、 the number of embryos,and the concentration of omentin showed a negative correlation with BMI 、 LDL and positive correlation with HDL,which suggested that modulating the concentration of visfatin in the local microenvironment of patients with PCOS may improve the pregnancy outcome.3.The concentration of visfatin and omentin-1 in follicular fluid may be a good predictor of the pregnancy outcome in patients underwent IVF. |
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