Clinical Observation Of Acid-Base Balance In Patients With PCOS Under Controlled Ovarian Hyperstimulation

Objective:Investigate the distribution of venous blood gas analysis,biochemistry,blood routine,and blood coagulation in patients with PCOS,NOR,and DOR before clinical intervention of COH;compare the changes of related indexes of peripheral blood in each group and between groups of PCOS and NOR before and after clinical COH intervention;explore the distribution of corresponding indicators in follicular fluid of the two groups,and analyze the possible causes of different distribution levels and the relationship between the difference and the clinical observation indicators at different stages after COH,to reveal the law of egg maturation and embryo development potential.Methods:Patients diagnosed polycystic ovary syndrome or polycystic ovary syndrome with tubal factor infertility,simple tubal infertility,and low ovarian reserve function were selected to be conducted the cross-sectional study from December 2018to March 2019.Patients with polycystic ovary syndrome or polycystic ovary syndrome with tubal factors infertility were selected as the observation group,patients with infertility due to tubal factors as a control group for the clinical observation study of COH intervention.Results:There was no significant difference in the distribution of peripheral blood venous gas,protein and amino acid,uric acid and lipid in patients with infertility before COH intervention.COH intervention changed a variety of indicators:patients blood was diluted and tended to hypercoagulable state,decomposition of albumin and other proteins enhanced,FIB and other stress proteins synthesis increased,glucose oxidative phosphorylation level rose,while it did not affect the HB concentration of PCOS group.The negative value of body fluid BE in the PCOS group was higher,and the ability was lower what balanced pH by ion transport and redistribution during COH.The pH of follicular fluid was higher and PCO₂ was lower during PCOS group.With the follicular fluid pH decreasing,the standard rate of MII eggs increased.However,the rate of corresponding four-level embryos was high,and the rate of high-quality embryos was low;the level of final high-quality embryos in embryonic culture was comparable to that of the control group,but the proportion of dead embryos was higher;this was mainly associated with the function of the cells themselves and the high level of total serum E₂ but the low stage of the average E₂from each follicle during COH process.Conclusions:In the PCOS patients,the acid-base metabolism in the basal state and during COH was in the normal range,but the alkali reserve was low;after COH,the body fluids were shifted from the acid to base state,the oxidative phosphorylation level of the follicular cells was higher,and the embryos of death were of larger amount while the high-quality embryos were smaller.The treatment of this group is mostly to improve the underlying endocrine and metabolic state,effectively control the number of follicles and serum total E₂ levels,and again,increase the synthesis of E₂ level from single follicle during COH.