[Effects of oral contraceptive pretreatment on controlled ovarian hyperstimulation and outcomes of IVF-ET].

OBJECTIVE: To investigate the effects of oral contraceptive pretreatment (OCP) in patients with polycystic ovarian syndrome (PCOS) undergoing controlled ovarian hyperstimulation for IVF-ET. METHODS: We randomly divided 85 patients with P-COS undergoing IVF-ET into an OCP (n = 53) and a control group (n = 32), the former received OCP, while the latter did not before the cycle. We retrospectively analyzed the data of the patients for the ovulation promoting effect of OCP and its influence on the incidence of ovarian hyperstimulation syndrome (OHSS) and outcomes of IVF-ET. RESULTS: Compared with the control group, OCP significantly reduced the formation of ovarian cyst (P < 0.05), remarkably increased the duration of gonadotropin stimulation and consumption (P < 0.01) , and markedly raised the percentage of mature ova (87.92% vs 92.85%, P < 0.05). But no significant differences were observed between the two groups in the incidences of moderate and severe OHSS, number of retrieved oocytes, and rates of fertilization, miscarriage and clinical pregnancy. CONCLUSION: OCP for patients with PCOS can help to control the time of ovarian stimulation, improve the synchronism of follicular development, and increase the duration of gonadotropin stimulation and consumption, but cannot change the incidences of moderate and severe OHSS.

Low-grade chronic inflammation in the peripheral blood and ovaries of women with polycystic ovarian syndrome.

The purpose of this study was to investigate chronic inflammation in the peripheral blood and ovaries of patients with polycystic ovary syndrome (PCOS). 86 PCOS patients and 50 controls were randomly enrolled in the study. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), blood routine test, lipid metabolism index, inflammation cytokines were detected. Ovary samples from PCOS group and control group were collected for macrophage and lymphocyte immunohistochemistry staining. Patients with PCOS showed significantly higher serum CRP, lymphocytes, monocytes, eosinophilic granulocytes, as well as higher triglycerides (TG), TNF-α and IL-6. PCOS ovary had greater number of macrophages and lymphocytes immersed throughout. In conclusion, PCOS patients exhibited hypertriglyceridemia and chronic inflammation, with elevated peripheral lymphocytes, monocytes, and eosinophilic granulocytes. In addition, their ovaries showed persistent chronic inflammation with a larger number of inflammatory cells immersed.

[Effect of luteinizing hormone vs follicular stimulating hormone ratio on anti-Müllerian hormone secretion and folliculogenesis in patients with polycystic ovarian syndrome].

OBJECTIVE: To investigate characteristics of anti-Müllerian hormone (AMH) secretion and mechanism of aberrant folliculogenesis by the ratio of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) in polycystic ovarian syndrome (PCOS) patients. METHODS: Base on the ratio of LH/FSH, total 95 patients with PCOS were divided into two groups, including 49 cases in higher ratio group (LH/FSH ≥ 2) and 46 cases in normal ratio group (LH/FSH < 2) matched with 62 infertile cases with tubal factor and regular menstruation as control group. Body mass index (BMI) were calculated in all objectives. The serum AMH were detected by enzyme linked immunosorbent assay (ELISA). Ovarian sexual hormones, fasting blood glucose, insulin and lipid were measured by chemiluminescence method. The correlation between AMH and metabolic index was analyzed by multilinear regression. RESULTS: (1) AMH: the serum level of AMH were (7.2 ± 4.3) µg/L in higher LH/FSH group, (5.2 ± 3.8) µg/L in normal LH/FSH group and (3.7 ± 2.2) µg/L in control group, which all reached significant difference among those 3 groups (P < 0.01). (2) The correlation between AMH and biological metabolic index: estradiol (E(2)) was negatively correlated with serum level of AMH in higher LH/FSH ratio group (r = -0.318). The serum level of AMH were positively correlated with BMI, fasting glucose, homeostasis model assessment insulin resistance index (HOMA-IR) in normal LH/FSH ratio group (r = 0.493, 0.362, 0.303). After controlling affect factors, serum levels of AMH were positively correlated with LH/FSH in higher LH/FSH ratio group (r = 0.301), but negatively correlated with E2 (r = -0.429). However, in normal LH/FSH group, serum level of AMH was only positively correlated with BMI (r = 0.428). CONCLUSION: The PCOS patients with higher LH/FSH ratio are primarily caused by hypothalamic-pituitary dysfunction, while the PCOS patients with normal LH/FSH ratio are mainly caused by metabolic disorders.

[Variance of serum prolactin in controlled ovarian stimulation].

OBJECTIVE: To investigate the variance of peripheral blood prolactin (PRL) in controlled ovarian stimulation. METHODS: Seventy-two patients, with totally 106 cycles receiving a long protocol of gonadotropin-releasing hormone agonist combined with gonadotropin (Gn) were randomly enrolled in this retrospective study. During controlled ovarian stimulation, peripheral blood hormones were measured by chemiluminescent microparticle immunoassay. RESULTS: Prolactin was positively correlated with estradiol (r = 0.5897, P < 0.01) while there was no significant correlation between luteinizing hormone and PRL Progesterone had a positive relation with prolactin (r = 0.1412, P < 0.01). CONCLUSIONS: During controlled ovarian stimulation, prolactin secretion is not affected by Gn but may be stimulated by estradiol. Progesterone has a positive relation with prolactin.