Objective:To explore the effect of insulin resistance (IR) on clinical outcomes after first embryo transfer during in vitro fertilization (IVF) treatment in polycystic ovarian syndrome (PCOS) patients. Methods:In this retrospective study, a total of 1 105 PCOS patients and 2 136 non-PCOS (control) patients with first embryo transfer from January 2018 to December 2020 in Reproductive Medical Center, Henan Provincial People's Hospital were recruited. All the patients were divided into four groups according to whether they had IR or not: PCOS with IR group (group A1); PCOS without IR (group A2); control with IR (group B1); control without IR (group B2). Baseline data and clinical outcomes were compared among the four groups.Results:1) There were significant differences in number of oocytes punctured (16.8±8.1, 17.8±7.9, 12.6±6.2, 13.4±6.2; P<0.001), number of oocytes retrieved (14.2±7.9, 15.3±7.7, 11.5±6.0, 12.3±6.3; P<0.001), the rate of oocytes retrieved [84.6% (8 518/10 070), 86.1% (7 738/8 986), 91.8% (8 346/9 096), 91.9% (17 367/18 898); P<0.001], the number of mature oocytes (12.1±7.0, 13.0±7.0, 9.7±5.3, 10.4±5.5; P<0.001), the number of two pronuclei (2PN) cleavage embryos (8.2±5.3, 9.0±5.4, 6.7±4.1, 7.4±4.3; P<0.001), the number of available embryos (7.1±4.8, 7.6±4.9, 5.7±3.7, 6.4±3.9; P<0.001), the rate of available embryos [82.3% (4 207/5 110), 82.2% (3 851/4 684), 82.3% (4 124/5 008), 83.9% (8 972/10 690); P=0.008], the number of high-quality embryos (3.7±3.4, 4.0±3.5, 3.2±2.7, 3.5±2.9; P<0.001), and the rate of high-quality embryos [42.8% (2 185/5 110), 43.5% (2 037/4 684), 45.7% (2 290/5 008), 46.9% (5 009/10 690); P<0.001], among group A1, group A2, group B1 and group B2 while the M Ⅱ rate, 2PN cleavage rate and available blastocyst formation rate were similar among the four groups (all P>0.05). 2) The rate of early miscarriage rate was significantly different among the four groups [16.3% (63/387), 9.7% (34/351), 12.1% (56/464), 8.7% (82/939); P=0.001], while the clinical pregnancy rate, the implantation rate and the ectopic rate were comparable (all P>0.05). Further subgroup analysis showed that the early miscarriage rate of group A1 [16.3% (63/387)] was significantly higher than that of group A2 [9.7% (34/351), P=0.008] and group B2 [8.7% (82/939), P<0.001]. 3) Multivariate logistic regression analysis suggested that IR was the independent factor of early miscarriage ( OR=1.464, 95% CI: 1.361-2.065, P=0.019). Conclusion:IR may play an important role in the early miscarriage results in PCOS patients during IVF treatment.

Objective:To explore the effect of insulin resistance (IR) on clinical outcomes after first embryo transfer during in vitro fertilization (IVF) treatment in polycystic ovarian syndrome (PCOS) patients. Methods:In this retrospective study, a total of 1 105 PCOS patients and 2 136 non-PCOS (control) patients with first embryo transfer from January 2018 to December 2020 in Reproductive Medical Center, Henan Provincial People's Hospital were recruited. All the patients were divided into four groups according to whether they had IR or not: PCOS with IR group (group A1); PCOS without IR (group A2); control with IR (group B1); control without IR (group B2). Baseline data and clinical outcomes were compared among the four groups.Results:1) There were significant differences in number of oocytes punctured (16.8±8.1, 17.8±7.9, 12.6±6.2, 13.4±6.2; P<0.001), number of oocytes retrieved (14.2±7.9, 15.3±7.7, 11.5±6.0, 12.3±6.3; P<0.001), the rate of oocytes retrieved [84.6% (8 518/10 070), 86.1% (7 738/8 986), 91.8% (8 346/9 096), 91.9% (17 367/18 898); P<0.001], the number of mature oocytes (12.1±7.0, 13.0±7.0, 9.7±5.3, 10.4±5.5; P<0.001), the number of two pronuclei (2PN) cleavage embryos (8.2±5.3, 9.0±5.4, 6.7±4.1, 7.4±4.3; P<0.001), the number of available embryos (7.1±4.8, 7.6±4.9, 5.7±3.7, 6.4±3.9; P<0.001), the rate of available embryos [82.3% (4 207/5 110), 82.2% (3 851/4 684), 82.3% (4 124/5 008), 83.9% (8 972/10 690); P=0.008], the number of high-quality embryos (3.7±3.4, 4.0±3.5, 3.2±2.7, 3.5±2.9; P<0.001), and the rate of high-quality embryos [42.8% (2 185/5 110), 43.5% (2 037/4 684), 45.7% (2 290/5 008), 46.9% (5 009/10 690); P<0.001], among group A1, group A2, group B1 and group B2 while the M Ⅱ rate, 2PN cleavage rate and available blastocyst formation rate were similar among the four groups (all P>0.05). 2) The rate of early miscarriage rate was significantly different among the four groups [16.3% (63/387), 9.7% (34/351), 12.1% (56/464), 8.7% (82/939); P=0.001], while the clinical pregnancy rate, the implantation rate and the ectopic rate were comparable (all P>0.05). Further subgroup analysis showed that the early miscarriage rate of group A1 [16.3% (63/387)] was significantly higher than that of group A2 [9.7% (34/351), P=0.008] and group B2 [8.7% (82/939), P<0.001]. 3) Multivariate logistic regression analysis suggested that IR was the independent factor of early miscarriage ( OR=1.464, 95% CI: 1.361-2.065, P=0.019). Conclusion:IR may play an important role in the early miscarriage results in PCOS patients during IVF treatment.

Objective:To explore the effect of anti-Müllerian hormone (AMH) on early pregnancy loss after first embryo transfer during in vitro fertilization (IVF) treatment. Methods:A total of 3973 women with positive human chorionic gonadotropin (hCG) after first embryo transfer from July 2016 to June 2019 in Reproductive Medical Center, Henan Provincial People's Hospital were studied retrospectively. All patients were categorized into four groups according to AMH levels: group A (AMH≤1.97 μg/L), group B (1.97 μg/L5.41 μg/L). Univariate analysis, multivariate logistic regression analysis and curve fitting analysis were used to investigate the effect of AMH level on early pregnancy loss rate.Results:1) The total early pregnancy loss rate of the first transfer cycle was 15.71% (624/3973).There were significant differences in AMH level [(1.21±0.50) μg/L, (2.63±0.38) μg/L, (4.26±0.60) μg/L, (8.26±2.78) μg/L, P<0.001], age [(32.35±5.00) years, (30.77±4.24) years, (29.90±3.96) years, (29.35±3.85) years, P<0.001], antral follicular count of both ovaries (8.01±4.04, 11.46±4.40, 13.55±4.73, 16.08±5.08, P<0.001), number of transfer embryos (1.74±0.44, 1.73±0.45, 1.69±0.46, 1.66±0.47, P<0.001), developmental days of transfer embryos (cleavage embryos/blastocysts) (85.49%/14.51%, 76.42%/23.58%, 69.55%/30.45%, 65.79%/34.21%, P<0.001), type of transfer cycles (fresh transfer/frozen transfer) (75.08%/24.92%, 71.15%/28.85%, 57.79%/42.21%, 39.46%/60.54%, P<0.001) and early pregnancy loss rate (22.12%, 12.25%, 12.76%, 15.64%, P<0.001) among the four groups, while the body mass index, type of infertility and type of fertilization were comparable (all P>0.05). 2) After adjusting for confounding factors, group A was set as control group in multivariate logistic regression analysis, the early pregnancy loss rate was significantly lower in group B (adjusted OR=0.60, 95% CI=0.46-0.79, P<0.001) and group C (adjusted OR=0.70, 95% CI=0.51-0.97, P=0.033) for the total women. Further multivariate logistic regression analysis according to age sub-groups showed that the early pregnancy loss rates of group B (adjusted OR=0.46, 95% CI=0.30-0.71, P<0.001), group C (adjusted OR=0.62, 95% CI=0.39-0.98, P=0.041) and group D (adjusted OR=0.56, 95% CI=0.33-0.93, P=0.026) were significantly lower than those in group A for women no more than 35 years old, while the early pregnancy rates were comparable among the four groups for women aged 35 years or above (all P>0.05). The curve fitting analysis found that the relationship between AMH and early pregnancy loss was a curve line. The early pregnancy loss rate was decreased with the increasing of AMH level and gradually plateaued. Conclusion:For the first embryo transfer cycles, AMH level has some effects on the early pregnancy loss for women no more than 35 years old.

Objective:To explore the effect of anti-Müllerian hormone (AMH) on early pregnancy loss after first embryo transfer during in vitro fertilization (IVF) treatment. Methods:A total of 3973 women with positive human chorionic gonadotropin (hCG) after first embryo transfer from July 2016 to June 2019 in Reproductive Medical Center, Henan Provincial People's Hospital were studied retrospectively. All patients were categorized into four groups according to AMH levels: group A (AMH≤1.97 μg/L), group B (1.97 μg/L5.41 μg/L). Univariate analysis, multivariate logistic regression analysis and curve fitting analysis were used to investigate the effect of AMH level on early pregnancy loss rate.Results:1) The total early pregnancy loss rate of the first transfer cycle was 15.71% (624/3973).There were significant differences in AMH level [(1.21±0.50) μg/L, (2.63±0.38) μg/L, (4.26±0.60) μg/L, (8.26±2.78) μg/L, P<0.001], age [(32.35±5.00) years, (30.77±4.24) years, (29.90±3.96) years, (29.35±3.85) years, P<0.001], antral follicular count of both ovaries (8.01±4.04, 11.46±4.40, 13.55±4.73, 16.08±5.08, P<0.001), number of transfer embryos (1.74±0.44, 1.73±0.45, 1.69±0.46, 1.66±0.47, P<0.001), developmental days of transfer embryos (cleavage embryos/blastocysts) (85.49%/14.51%, 76.42%/23.58%, 69.55%/30.45%, 65.79%/34.21%, P<0.001), type of transfer cycles (fresh transfer/frozen transfer) (75.08%/24.92%, 71.15%/28.85%, 57.79%/42.21%, 39.46%/60.54%, P<0.001) and early pregnancy loss rate (22.12%, 12.25%, 12.76%, 15.64%, P<0.001) among the four groups, while the body mass index, type of infertility and type of fertilization were comparable (all P>0.05). 2) After adjusting for confounding factors, group A was set as control group in multivariate logistic regression analysis, the early pregnancy loss rate was significantly lower in group B (adjusted OR=0.60, 95% CI=0.46-0.79, P<0.001) and group C (adjusted OR=0.70, 95% CI=0.51-0.97, P=0.033) for the total women. Further multivariate logistic regression analysis according to age sub-groups showed that the early pregnancy loss rates of group B (adjusted OR=0.46, 95% CI=0.30-0.71, P<0.001), group C (adjusted OR=0.62, 95% CI=0.39-0.98, P=0.041) and group D (adjusted OR=0.56, 95% CI=0.33-0.93, P=0.026) were significantly lower than those in group A for women no more than 35 years old, while the early pregnancy rates were comparable among the four groups for women aged 35 years or above (all P>0.05). The curve fitting analysis found that the relationship between AMH and early pregnancy loss was a curve line. The early pregnancy loss rate was decreased with the increasing of AMH level and gradually plateaued. Conclusion:For the first embryo transfer cycles, AMH level has some effects on the early pregnancy loss for women no more than 35 years old.

Objective:To explore the cumulative delivery rate and related factors of infertile women with anti-Müllerian hormone (AMH) no more than 1 μg/L during in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods:In this retrospective cohort study, we analyzed 793 infertile women with AMH no more than 1 μg/L and underwent their first IVF-ET treatment in Henan Provincial People's Hospital between July 2016 and February 2018. All the patients were categorized into two groups according to cumulative delivery with at least one live baby or not. Baseline data and outcomes were compared between the two groups. The regression analysis was conducted to identify the independent factors of cumulative delivery rate and clinical outcomes of different age groups were compared.Results:1) The total cumulative delivery rate per start cycle was 23.83% (189/793). There were significant differences in age [33(30,37) years vs. 39(34,43) years], AMH [0.67(0.46,0.87) μg/L vs. 0.51(0.22,0.74) μg/L], antral follicle count (AFC) [6(4,8) vs. 4(2,6)], basal follicle-stimulating hormone (bFSH) [9.11(6.98,11.03) IU/L vs. 11.06(7.75,13.13) IU/L], starting dosage of gonadotropin (Gn) used [225.0(187.5,225.0) IU vs. 225.0(225.0,300.0) IU], total dosage of Gn used [2 475.0(1 800.0,3 137.5) IU vs. 2 100.0(1 575.0,2 850.0) IU], duration of Gn stimulation [10(8,12) d vs. 9(6,11) d], number of oocytes retrieved [5.0(3.0,7.5) vs. 2.5(1.0,4.0)], number of M II oocytes [4(3,6) vs. 2(1,3)] and number of available cleavage embryos [3.0(2.0,4.5) vs.1.0(0,2.0)] between the two groups (all P<0.001). 2) Multivariate logistic regression analysis suggested that age ( OR=0.878, 95% CI=0.846-0.911, P<0.001) was the vital factor of cumulative delivery rate. The cumulative pregnancy rate and the cumulative delivery rate were significantly decreased with age increasing (all P<0.001). And the cancelation rate of group with age more than 40 years was much higher ( P<0.001). Conclusion:Age was the independent influencing factor of cumulative delivery rate. The cumulative delivery rate decreased significantly with age increasing.

Objective:To explore the cumulative delivery rate and related factors of infertile women with anti-Müllerian hormone (AMH) no more than 1 μg/L during in vitro fertilization and embryo transfer (IVF-ET) treatment. Methods:In this retrospective cohort study, we analyzed 793 infertile women with AMH no more than 1 μg/L and underwent their first IVF-ET treatment in Henan Provincial People's Hospital between July 2016 and February 2018. All the patients were categorized into two groups according to cumulative delivery with at least one live baby or not. Baseline data and outcomes were compared between the two groups. The regression analysis was conducted to identify the independent factors of cumulative delivery rate and clinical outcomes of different age groups were compared.Results:1) The total cumulative delivery rate per start cycle was 23.83% (189/793). There were significant differences in age [33(30,37) years vs. 39(34,43) years], AMH [0.67(0.46,0.87) μg/L vs. 0.51(0.22,0.74) μg/L], antral follicle count (AFC) [6(4,8) vs. 4(2,6)], basal follicle-stimulating hormone (bFSH) [9.11(6.98,11.03) IU/L vs. 11.06(7.75,13.13) IU/L], starting dosage of gonadotropin (Gn) used [225.0(187.5,225.0) IU vs. 225.0(225.0,300.0) IU], total dosage of Gn used [2 475.0(1 800.0,3 137.5) IU vs. 2 100.0(1 575.0,2 850.0) IU], duration of Gn stimulation [10(8,12) d vs. 9(6,11) d], number of oocytes retrieved [5.0(3.0,7.5) vs. 2.5(1.0,4.0)], number of M II oocytes [4(3,6) vs. 2(1,3)] and number of available cleavage embryos [3.0(2.0,4.5) vs.1.0(0,2.0)] between the two groups (all P<0.001). 2) Multivariate logistic regression analysis suggested that age ( OR=0.878, 95% CI=0.846-0.911, P<0.001) was the vital factor of cumulative delivery rate. The cumulative pregnancy rate and the cumulative delivery rate were significantly decreased with age increasing (all P<0.001). And the cancelation rate of group with age more than 40 years was much higher ( P<0.001). Conclusion:Age was the independent influencing factor of cumulative delivery rate. The cumulative delivery rate decreased significantly with age increasing.