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Pregnancy outcomes of women with polycystic ovary syndrome for the first in vitro fertilization treatment: A retrospective cohort study with 7678 patients
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  • Su Liu,
  • Meilan Mo,
  • Shan Xiao,
  • Longfei Li,
  • Xiuyu Hu,
  • Ling Hong,
  • Linlin Wang,
  • Ruochun Lian,
  • Chunyu Huang,
  • Yong Zeng,
  • Lianghui Diao
Su Liu
Shenzhen Zhongshan Urology Hospital
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Meilan Mo
Shenzhen Zhongshan Urology Hospital
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Shan Xiao
Shenzhen Zhongshan Urology Hospital
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Longfei Li
Shenzhen Zhongshan Urology Hospital
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Xiuyu Hu
Shenzhen Zhongshan Urology Hospital
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Ling Hong
Shenzhen Zhongshan Urology Hospital
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Linlin Wang
Shenzhen Zhongshan Urology Hospital
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Ruochun Lian
Shenzhen Zhongshan Urology Hospital
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Chunyu Huang
Shenzhen Zhongshan Urology Hospital
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Yong Zeng
Shenzhen Zhongshan Urology Hospital, Shenzhen University
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Lianghui Diao
Shenzhen Zhongshan Urology Hospital
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Abstract

Objective: To evaluate whether polycystic ovary syndrome (PCOS) affects pregnancy outcomes and complications in infertile women undergoing their first in vitro fertilization (IVF) treatment. Design: A retrospective cohort study. Setting: Private fertility center. Population: 7678 infertile women, including 666 women with PCOS and 7012 controls undergoing their first IVF treatment from 2010 to 2017. Methods: Maternal characteristics, pregnancy outcomes and complications were analyzed by independent t-test, Mann-Whitney U-test, or Chi-square test. A logistic regression analysis was performed to determine the impact of PCOS on pregnancy outcomes and complications. Main Outcome Measures: Risk of adverse pregnancy outcomes (miscarriage, preterm delivery, pregnancy-induced hypertension) and pregnancy outcomes (live birth rate, clinical pregnancy rate, implantation rate), adjusted for maternal characteristics. Results: After adjusting for differences in maternal age, BMI, infertility duration, total dose of gonadotropin, serum E2 and endometrial thickness on the day of hCG trigger, number of fertilized occytes, number of embryos transferred, embryo type (cleavage-stage embryo or blastocyst) and quality, women with PCOS had an increased risk of developing unfavorable pregnancy complications, including miscarriage (adjusted odds ratio [aOR] 1.629, 95% confidence interval [CI] 1.240-2.141), very preterm delivery (< 32 weeks) (aOR 2.135, 95% CI 1.170-3.895). For pregnancy outcomes, PCOS was associated with higher clinical pregnancy rate (aOR 1.248, 95% CI 1.038-1.501) and implantation rate (aOR 1.238, 95% CI 1.030-1.489) after adjusting for the above-mentioned confounders. Conclusions: Women with PCOS are at increased risk of adverse pregnancy outcomes. These women may need more frequent medical consultants and management during pregnancy and parturition.