Pregnancy outcomes of women with polycystic ovary syndrome for the first
in vitro fertilization treatment: A retrospective cohort study with 7678
patients
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.