多囊卵巢综合征合并不孕患者血清FGF19、INHA水平及其对IVF-ET后妊娠结局的预测价值OA

Objective To investigate the serum levels of fibroblast growth factor 19(FGF19)and inhibin A(INHA)in infertile patients with polycystic ovary syndrome(PCOS)and their predictive value for preg-nancy outcomes.Methods A total of 96 PCOS patients undergoing in vitro fertilization-embryo transfer(IVF-ET)treatment admitted to the hospital from January 2022 to August 2024 were selected as the study group,and 96 healthy married women with regular menstrual cycles who underwent physical examinations at the hospital during the same period and had given birth were selected as the control group.Serum levels of FGF19,INHA and fasting insulin,testosterone(T)were measured in all subjects,and the insulin resistance index(HOMA-IR)was calculated.According to pregnancy outcomes,patients in the study group were divided into a pregnant group and a non-pregnant group.Pearson correlation analysis was used to explore the correla-tion between serum FGF19 level and INHA level in non-pregnant PCOS group,as well as their relationship with fasting insulin level,HOMA-IR and serum T level.Multivariate Logistic regression analysis was used to analyze the influencing factors associated with non-pregnancy after IVF-ET in PCOS patients with infertile.Receiver operating characteristic(ROC)curves were plotted to analyze the diagnostic value of serum FGF19 and INHA for PCOS,as well as their predictive value for non-pregnancy after IVF-ET in PCOS patients with infertile.Results The serum FGF19 and INHA levels in the study group were lower than those in the control group,while fasting insulin level,HOMA-IR and serum T level were higher than those in the control group,with statistically significant differences(P<0.05).ROC curve analysis results showed that the areas under the curves(AUCs)of serum FGF19,INHA alone and in combination for diagnosing PCOS with infertile were 0.802,0.792 and 0.884,respectively,and the AUC of the combined diagnosis of the two indicators for PCOS was significantly larger than that of serum FGF19 and INHA alone(Z=2.422,2.431,both P<0.05).There were 51 cases in the pregnant group and 45 cases in the non-pregnant group.The serum FGF19 and INHA levels in the non-pregnant group were lower than those in the pregnant group,while fasting insulin level,HO-MA-IR and serum T level were higher than those in the pregnant group,with statistically significant differ-ences(P<0.05).Pearson correlation analysis results showed that serum FGF19 level in non-pregnant group was positively correlated with serum INHA level(P<0.05),and both serum FGF19 and INHA levels were negatively correlated with fasting insulin level,HOMA-IR and serum T level(P<0.05).Multivariate Logis-tic regression analysis results showed that increased serum FGF19 and INHA levels were protective factors for non-pregnancy after IVF-ET in PCOS patients with infertile(P<0.05),while increased HOMA-IR and serum T level were risk factors for non-pregnancy after IVF-ET(P<0.05).ROC curve analysis results showed that the AUCs of serum FGF19,INHA alone and in combination for predicting non-pregnancy after IVF-ET in PCOS patients with infertile were 0.904,0.883 and 0.959 respectively,and the AUC of the com-bined prediction of both indicators was larger than that of serum FGF19 and INHA alone(Z=2.476,2.492,both P<0.05).Conclusion Serum FGF19 and INHA levels are decreased in infertile patients with PCOS,both of which are related to pregnancy outcomes,and their combined prediction has higher clinical value for non-pregnancy after IVF-ET in PCOS patients with infertile.