Objectives:To investigate the clinical outcomes of long agonist protocol in predicted hyper responders, and to explore the risk factors associated with hyper ovarian response in these patients.Methods:In this retrospective case-control study, 664 predicted hyper responders were included. All patients were from Reproductive Center of Fujian Maternity and Child Health Hospital, and were in treatment during January 1, 2016 and June 1, 2019. Logistic regression was applied to screen out the independent risk factors of hyper ovarian response. The prediction accuracy of the independent risk factors was evaluated by calculating the area under the receiver operating characteristic curve (AUC).Results:Totally 10 (1.51%) of all patients occurred poor ovarian response, 356 (53.61%) of all patients achieved normal ovarian response, and 298 (44.88%) of them got hyper ovarian response. The rate of moderate-to-severe ovarian hyperstimulation syndrom (OHSS) from normal response group [3.09% (11/356)] was significantly lower than that from hyper response group [8.39% (25/298), P=0.003]. The rate of clinical pregnancy per transfer showed no statistical significance between the two groups ( P>0.05). The miscarriage rate was more than two times in normal response group compared with high response group, but without statistical significance ( P>0.05). Multivariate logistic regression analysis showed that luteinizing hormone (LH) level on human chorionic gonadotropin (hCG) injection day was negatively correlated with the occurrence of hyper ovarian response. The AUC of LH level on hCG injection day was 0.594. LH level on hCG injection day ≤1.0 IU/L was an independent risk factor of hyper ovarian response. Conclusion:Long agonist protocol is a good option for predicted hyper responders. LH supplementation might be helpful in controlled ovarian stimulation to reduce the incidence of hyper ovarian response.

Objectives:To investigate the clinical outcomes of long agonist protocol in predicted hyper responders, and to explore the risk factors associated with hyper ovarian response in these patients.Methods:In this retrospective case-control study, 664 predicted hyper responders were included. All patients were from Reproductive Center of Fujian Maternity and Child Health Hospital, and were in treatment during January 1, 2016 and June 1, 2019. Logistic regression was applied to screen out the independent risk factors of hyper ovarian response. The prediction accuracy of the independent risk factors was evaluated by calculating the area under the receiver operating characteristic curve (AUC).Results:Totally 10 (1.51%) of all patients occurred poor ovarian response, 356 (53.61%) of all patients achieved normal ovarian response, and 298 (44.88%) of them got hyper ovarian response. The rate of moderate-to-severe ovarian hyperstimulation syndrom (OHSS) from normal response group [3.09% (11/356)] was significantly lower than that from hyper response group [8.39% (25/298), P=0.003]. The rate of clinical pregnancy per transfer showed no statistical significance between the two groups ( P>0.05). The miscarriage rate was more than two times in normal response group compared with high response group, but without statistical significance ( P>0.05). Multivariate logistic regression analysis showed that luteinizing hormone (LH) level on human chorionic gonadotropin (hCG) injection day was negatively correlated with the occurrence of hyper ovarian response. The AUC of LH level on hCG injection day was 0.594. LH level on hCG injection day ≤1.0 IU/L was an independent risk factor of hyper ovarian response. Conclusion:Long agonist protocol is a good option for predicted hyper responders. LH supplementation might be helpful in controlled ovarian stimulation to reduce the incidence of hyper ovarian response.

Objective To explore the effect of carotid atherosclerotic plaque ( CAP) on severity and recurrence of patients with cerebral infarction ( CI ) .Methods The prospective cohort study was utilized in this research. Existence and type of CAP were detected by Doppler ultrasound, and patients were divided into plaque group and without plaque group.The patients was evaluated by NIHSS on admission and 7 d, 14 d after admission, and patients were followed up for 1 year.The condition of CI recurrence was be observed.Results According to the Doppler ultrasound, patients were divided into plaque group ( 173 cases, 70.3%) and without plaque group ( 73 cases, 29.7%) .Compared with without plaque group, age, NIHSS score and incidences of hypertension, diabetes, hyperlipidemia, hyperfibrinogenemia were significantly increased (P<0.05 -0.01).In the patients who were conducted follow-up, cerebral infarction recurrence was in 39 cases (24.84%) in plaque group, recurrence time was 10.12 month.The recurrence time was 11.82 month in patient with non-vulnerable plaque, it was 10.62 month in patient with mixed plaque, and it was 9.13 month in patient with vulnerable plaque.Cerebral infarct recurrence was in 7 cases (10.45%) in without plaque group, recurrence time was 11.56 month.The recurrence rate in plaque group was significant increased than that in without plaque, however, the recurrence time for without plaque group was longer than that for plaque group ( all P<0.05 ) .The recurrence rate and recurrence time in patient with vulnerable plaque was significantly earlier than that in patient with non-vulnerable plaque (P=0.034).Conclusion The CAP in patients with acute CI can exacerbate the disease, and increase recurrence rate.It is especially in patients with vulnerable plaque.