Analysis Of The Effect Of Blood Lipid Concentration On The Treatment Of In Vitro Fertilization And Embryo Transfer

Objective:To assess the predictive value of ovarian reactivity,it is necessary to look into the relationship between blood lipid concentration（TG,TC and LDL）and the predictor of ovarian reactivity.How blood lipid levels affect the outcome of the treatment of in vitro fertilization and embryo transfer（IVF-ET）.Methods:The 1,230 patients who received reproductive assisted pregnancy services for the first time in 2021 were chosen as the research subjects.They were categorized into 77 cases of low ovarian response,795 cases of normal ovarian response and 358 cases of high ovarian response based on the number of oocytes retrieve.Each group’s observation indices were compared,and the receiver operating characteristic curve was used to assess the prediction power of each ovarian response index.Each ovarian response was separated into three sections based on body mass index:normal weight group,overweight group,obesity group.Then,Pearson correlation analysis was used to compare the relationship between blood lipid concentration and ovarian reactivity indicators in each subgroup.In addition,the TG,TC and LDL concentrations of the three ovarian response groups were divided into three subgroups based on the appropriate level,marginal elevation and elevation,in accordance with Chinese guidelines for the prevention and treatment of dyslipidemia,each subgroup’s IVF-ET treatment data were compared.By using logistic regression,the affecting factors of the clinical pregnancy rate were examined in the end.Results:1.Comparison of observation indexes among ovarian response groups:The lower the ovarian responsiveness,the higher the age,basal follicle stimulating hormone（b FSH）and basal estradiol（b E₂）,the lower the antral follicle number（AFC）and anti-Mullerian hormone（AMH）,and vice versa.These results suggest that they have predictive value for ovarian response.2.Receiver operating characteristic curve:When a single factor predicts low and high ovarian response,the area under the curve of AMH was 0.693 and 0.705respectively that is the largest,indicating that AMH is the best indicator to predict ovarian response.The area under the curve of low ovarian response can be increased by combined detection（age,b FSH,b E₂,AMH,AFC）.3.Pearson’s Correlation Analysis:⑴There was a positive correlation between b FSH and LDL in normal weight group with low ovarian response（r=0.291,P=0.036）.⑵There was a negative correlation between AFC and TC in overweight group with normal ovarian response（r=-0.150,P=0.044）.⑶The high ovarian response super recombinant b FSH was positively correlated with LDL（r=0.240,P=0.045）,b E₂ and TG（r=0.378,P=0.001）,and the obese group AMH and LDL（r=0.689,P=0.013）.It suggests that,to some extent,the higher the blood lipid concentration,the higher the b FSH,b E₂ and AMH,and the lower AFC.The results also showed that the higher b FSH and b E₂,and the lower AFC,the lower the ovarian responds while the higher the AMH,the higher the ovarian responds.It is suggested that the increase of blood lipid concentration may increase the level of b FSH,b E₂ and decrease AFC,and decrease the ovarian reactivity,or increase the level of AMH and increase the ovarian reactivity.4.When the TG concentration was at the elevation level,the total amount of exogenous gonadotropin（Gn）was the highest in both low and high ovarian response groups;When the TG concentration was at the proper level,the Gn priming dose for the normal ovarian response group was lower than the TG elevation level,but the double pronuclear（2PN）and normal fertilization rate were higher;The number of optimal embryos were higher when TC and LDL were at the proper levels than they were at the elevation levels.5.Logistic regression analysis revealed that number of optimal embryos[OR=1.083,95%CI（1.019～1.151）],2PN[OR=0.919,95%CI（0.885～0.954）]and normal fertilization rate[OR=1.019,95%CI（1.012～1.026）]were all independent risk factors for clinical pregnancy.It is suggested that the clinical pregnancy rate will decrease with the reduction of the three.Conclusion:1.Age,b FSH,b E₂,AMH and AFC have predictive value for ovarian response and can be used to predict ovarian reactivity.Taking a single test,AMH was the most accurate predictor of ovarian low and high response,and combining five tests could increase the accuracy of low ovarian response prediction.2.Blood lipid concentration is related to the predictors of ovarian reactivity and has some predictive value for ovarian response.3.Number of optimal embryos,2PN and normal fertilization rate may all be diminished to varying degrees by an increase in blood TG,TC,and LDL levels,which would therefore result in a decreased pregnancy outcome of IVF-ET.