Objective To explore the predictive value of transvaginal ultrasound blood flow parameters combined with serum anti mullerian hormone (AMH) for in vitro fertilization embryo transfer (IVF-ET) pregnancy failure in infertility with polycystic ovary syndrome (PCOS).
Methods A total of 173 infertile PCOS patients who underwent IVF-ET were selected as the study objects, of which 12 cases fell off. According to the results of vaginal Bultrasound on the 28th day after embryo transfer, 161 patients were divided into failed pregnancy group (n=96) and successful pregnancy group (n=65). The levels of resistance index (RI), pulsatile index (PI), ratio of maximum systolic to diastolic blood flow velocity (S/D), and serum AMH were compared between the two groups. Multivariate Logistic regression analysis was used to analyze the influencing factors of pregnancy failure in IVF-ET with PCOS infertility. Receiver operating characteristic (ROC) curves were drawn to analyze RI, PI, S/D and serum AMH levels alone and their combination to evaluate the predictive valueof IVF-ET pregnancy failure in PCOS infertility patients.
Results The serum AMH level in the failed pregnancy group was significantly lower than that in the successful pregnancy group, and the blood flow RI, PI and S/D were higher than those in the successful pregnancy group (P < 0.001). RI (OR=4.688, 95%CI, 2.878 to 6.498), PI (OR=4.332, 95%CI, 2.277 to 6.387), S/D (OR=3.773, 95%CI, 1.856 to 5.691) and luteinizing hormone (LH)/follicle stimulating hormone (FSH) values on the third day of menstrual cycle (OR=2.998, 95%CI, 1.236 to 4.760) were the risk factors for pregnancy failure in PCOS infertility IVF-ET (P < 0.05); high FSH level on the third day of menstruation (OR=0.579, 95%CI, 0.416 to 0.806), high serum AMH level (OR=0.722, 95%CI, 0.533 to 0.911) and endometrial thickness on human chorionic gonadotropin (hCG)day (OR=0.632, 95%CI, 0.421 to 0.843) were protective factors for pregnancy failure in IVF-ET in PCOS infertility (P < 0.05). The sensitivity, specificity and area under the curve (AUC) of RI, PI and S/D combined with serum AMH levels in predicting pregnancy failure in IVF-ET of PCOS infertility were 95.83%, 80.00% and 0.933, respectively.
Conclusion The combination of ultrasonic blood flow parameters and AMH has a good value in predicting pregnancy failure in IVF-ET of PCOS infertility.
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