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| Effects of FOXL2 level in follicular fluid on dosage of gonadotropin used during superovulation and clinical outcomes |
| 1.Mingzhou Hospital of Zhejiang University, Ningbo, Zhejiang Province, 315000; 2.Aji'an (Fuzhou) Genetic Medicine Testing Laboratory; 3.Yinzhou Women and Children's Hospital, Mingzhou Hospital, Zhejiang University |
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Abstract To explore the effects of follicular fluid wing spiral/forkhead transcription factor gene 2 (FOXL2) of women on their dosage of gonadotropin (Gn) during superovulation and their clinical outcomes. Methods: 98 women with in vitro fertilization-embryo transfer or intracytoplasmic sperm injection were selected in this study from April 2017 to April 2020. According to the total dose of gonadotropin (Gn) used during ovulation induction, these women were divided into group A (29 women with <2000IU of Gn), group B (42 women with 2000-4000IU of Gn), and group C (27 women with ≥4000IU of Gn). The clinical data, the laboratory indicators, the pregnancy outcomes, and the levels of FOXL2 and serum estradiol (E2) on the day of human chorionic gonadotropin (hCG) used of these women were obtained. The risk factors affecting pregnancy of the women were analyzed. Results: The level of basal luteinizing hormone (LH) and the dosage of Gn used of the women in group A, group B, and group C had increased gradually, while the antrum follicles count (AFC), the number of harvested eggs, the rate of high-quality embryos, the FOXL2 level in follicular fluid, and the E2 level on the day of hCG used had decreased gradually (all P＜0.05). There were no significant differences in the normal fertilization rate and the clinical pregnancy rate of the women among the three groups (P＞0.05). The dosage of Gn used of the women with pregnancy was significantly lower than that of the women without pregnancy, but FOXL2 level in follicular fluid of the women with pregnancy was significantly higher (P＜0.05). Logistic regression analysis showed that excessive dosage of Gn used and decrease of FOXL2 level in follicular fluid of the women were the risk factors of pregnancy outcomes of the women after assisted reproductive technology (OR=2.285, 95%CI=1.287-5.195, P=0.021). Conclusion: The older of the women, the more dosage Gn was used. The increasing dosage of Gn used will reduce the level of FOXL2 in follicular fluid. The less dosage of Gn used during ovulation induction, the greater the ovarian response was to Gn. The level of FOXL2 increases, the ovarian response to hyperovulation drugs is greater, the number of eggs obtained is more, the rates of high-quality embryos and the clinical pregnancy are higher, which contribute to the outcomes of assisted reproduction.
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