1
|
Li J, Shi H, Bu Z, Kong H, Ye T, Guo Y. Effect of body mass index on the cumulative live birth rate over multiple complete IVF cycles in women with polycystic ovary syndrome: A retrospective study. Obes Res Clin Pract 2023; 17:130-136. [PMID: 36922274 DOI: 10.1016/j.orcp.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the effect of body mass index (BMI) before treatment on the cumulative live birth rate (CLBR) over multiple complete in vitro fertilization (IVF) cycles in patients with polycystic ovary syndrome (PCOS). MATERIALS AND METHODS This study is a single-center retrospective cohort study. It included 5016 patients with PCOS who started their first IVF cycle in our hospital between 2009 and 2018. Kaplan-Meier and log-rank tests were used for the comparison of CLBR across BMI groups. Univariate, multivariate models and stratification analysis were used to evaluate possible influencing factors of CLBR. Smoothing curve fitting was applied to present the correlation between BMI and CLBR. A one-line linear regression model was compared with a two-piecewise linear model using a log-likelihood ratio test. RESULTS During the 8-year follow-up, 3604 women (71.85%) obtained at least one live birth. The study population was grouped according to BMI, with BMI ranging from [14.53-23.00) kg/m2 in the normal weight group, [23.00-27.50) kg/m2 in the overweight group, and [27.50-37.80] kg/m2 in the obese group, respectively. The CLBR of the obese group and the overweight group were significantly lower than the normal weight group. In the multivariate regression model, HR for CLBR was 0.86 [95%CI: 0.78-0.95] for the obese group, and 0.93 [0.86-1.00] for the overweight group, compared with the normal weight group as control. The curve fitting after adjustment for confounding factors and log-likelihood ratio test showed a one-line linear negative correlation between BMI and CLBR. CONCLUSION We concluded that the BMI of PCOS patients had a negative one-line linear correlation with CLBR over multiple complete cycles.
Collapse
Affiliation(s)
- Jing Li
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China
| | - Hao Shi
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China
| | - Zhiqin Bu
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China
| | - Huijuan Kong
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China
| | - Tian Ye
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China
| | - Yihong Guo
- Reproduction and Genetics Hospital of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Henan Key Laboratory of Reproduction and Genetics, Zhengzhou, China.
| |
Collapse
|
2
|
The Effect of Age on IVF-ET Outcome in Infertile Patients with PCOS Based on Tiangui Theory in Chinese Medicine. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2977636. [PMID: 36045661 PMCID: PMC9423975 DOI: 10.1155/2022/2977636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
Abstract
Objective Our aim was to investigate the effect of age on the outcome of IVF-ET and ICSI in infertile PCOS patients under the guidance of Tiangui theory in traditional Chinese medicine. Method This was a retrospective analysis of 532 infertile women with PCOS and 1,392 women with infertility due to tubal factors as the controls. All of the participants were divided into different age groups-aged 20–28 years, 29–35 years, and ≥36 years-according to the stages of female reproductive development in Tiangui theory as described in the Canon of Internal Medicine-Treatise of Ancient Natural Truth. We explored the effect of age on controlled ovarian hyperstimulation (including the initial dosage and duration of Gn and the estradiol level on the day of human chorionic gonadotropin administration); the numbers of retrieved oocytes, 2PN zygotes, and embryos; and the rates of fertilization, clinical pregnancy, abortion, live birth, and OHSS incidence. Results Compared to controls, the maximum follicular diameter and the numbers of follicles with d ≥ 20 mm, retrieved oocytes, and 2PN zygotes were greater in the PCOS group with age >28 years (p < 0.05). The abortion rate of PCOS patients with age ≤28 years was higher than that of the controls. All PCOS groups and the control group showed reduced numbers of retrieved oocytes and live births with age. The difference in age was not significant in the PCOS groups but was significant in the control group (p < 0.05), and the trend in the PCOS groups was more gradual. Conclusion The fertility of all subjects decreased with age, but PCOS patients decreased more slowly than in controls at the same age, which verified the applicability of the guiding principles of Tiangui theory in the clinic.
Collapse
|
3
|
Effects of Vitamin D on Fertility, Pregnancy and Polycystic Ovary Syndrome-A Review. Nutrients 2022; 14:nu14081649. [PMID: 35458211 PMCID: PMC9029121 DOI: 10.3390/nu14081649] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/09/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is one of the most common endocrine reproductive disorders in women. Vitamin D deficiency is also quite common in this condition. The degree of vitamin D deficiency correlates with the severity of PCOS. Both male and female vitamin D levels play a role in fertility and affect the outcomes of in vitro fertilization (IVF). Moreover, fertility and IVF indicators are improved by vitamin D not only in healthy women but in those diagnosed with PCOS. Both vitamin D deficiency and PCOS increase pregnancy-related complications. Vitamin D supplementation and optimal vitamin D levels decrease both maternal and fetal risk for complications and adverse events. Furthermore, vitamin D supplementation may ameliorate or even prevent pregnancy-related reversible bone loss in mothers. This review emphasizes the roles of vitamin D deficiency and vitamin D supplementation and their correlation with PCOS regarding reproductive health.
Collapse
|
4
|
Shrem G, Salmon-Divon M, Mahfoudh AM, Balayla J, Volodarsky-Perel A, Henderson S, Zeadna A, Son WY, Steiner N, Dahan MH. Influence of Maternal Age and Ovarian Reserve on the Decision to Continue or to Cancel IVF Cycles in Patients with One or Two Large Follicles: a Dual Effect. Reprod Sci 2022; 29:291-300. [PMID: 34115367 DOI: 10.1007/s43032-021-00649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 05/30/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to study whether IVF stimulation that results in one or two mature follicles should proceed to oocyte retrieval. This is a retrospective cohort study conducted at McGill University Health Center on 459 patients who underwent IVF treatment between 2011 and 2014, undergoing hormonal stimulation and monitoring of their ovarian response. The primary outcomes were pregnancy and live birth rates. Statistical modeling was used to determine individual roles of patient age and ovarian reserve on outcomes, while controlling for the other factors. Of the 459 cycles included in the study, 360 cycles (78.4%) ended in embryo transfer. Live birth rates per cycle were 15.6%, for the ≤ 34-year-olds; 6.5%, for the 35-39-year-olds; and 2.7%, for the ≥ 40-year-olds (p < 0.01). Twenty-five percent of the cycles in the ≥ 40-year-old group were canceled versus 17% and 15% in the 35-39-year-old and ≤ 34-year-old groups, respectively (p < 0.05). Testing likelihood of live birth as a function of age and antral follicular count (AFC) revealed that a 1-year increase in age reduces the likelihood of live birth by 11% (p < 0.05) and one-unit increase in AFC count leads to a 9% increase in the odds of a live birth (p < 0.05). For the youngest age group, the AFC had a most significant effect, and those with AFC > 11 had 56% live birth rate, while those with AFC ≤ 11 had only 6% of live birth rate. This study supports a shift in reasoning from age being the predictor of outcomes in women with a low response at IVF to both age and ovarian reserve needing to be taken into consideration.
Collapse
Affiliation(s)
- Guy Shrem
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada.
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada.
- Department of Obstetrics and Gynecology, IVF Unit, Kaplan Medical Center, Rehovot, Israel.
| | - Mali Salmon-Divon
- Department of Molecular Biology, Ariel University, 40700, Ariel, Israel.
- Adelson School of Medicine, Ariel University, Ariel, Israel.
| | - Alina M Mahfoudh
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Jacques Balayla
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada
| | - Alexander Volodarsky-Perel
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel
| | - Sara Henderson
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Atif Zeadna
- Ben-Gurion University of the Negev, Medicine, Southern, Beer-Sheva, Israel
| | - Weon-Young Son
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| | - Naama Steiner
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
- Ben-Gurion University of the Negev, Medicine, Southern, Beer-Sheva, Israel
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, 845 Rue Sherbrooke O, Montréal, H3A 0G4, Canada
- MUHC Reproductive Center, McGill University, Montréal, QC, H2L 4S8, Canada
| |
Collapse
|
5
|
Guan Y, Kong P, Xiao Z, Zhang J, He J, Geng W, Yan J, Sun S, Mu M, Du X, Wang X. Independent Variables for Determining the Cumulative Live Birth Rates of Aged Patients with Polycystic Ovary Syndrome or Tubal Factor Infertility: A Retrospective Cohort Study. Front Endocrinol (Lausanne) 2021; 12:728051. [PMID: 35111134 PMCID: PMC8803204 DOI: 10.3389/fendo.2021.728051] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess whether women of advanced age (≥35 years) with polycystic ovary syndrome (PCOS) have the same cumulative live birth rate (CLBR) as their age-matched controls with tubal factor infertility and to determine the influencing factors on the CLBRs of aged women. DESIGN A retrospective cohort study. SETTING AND POPULATION A total of 160 women of advanced age (≥35 years) with PCOS and 1073 women with tubal factor infertility were included in our study. All patients underwent their first fresh cycles and subsequent frozen cycles within in one year in our centre from 2015 to 2020. METHODS To determine independent influencing factors on the CLBRs of these aged patients, a multivariable Cox regression model of CLBR according to the transfer cycle type was constructed. Main outcome measure(s): CLBRs. RESULT The Cox regression model of the CLBRs indicated that there was no significant difference between the PCOS group and the tubal infertility group in terms of advanced age (HR, 0.95; 95% CI, 0.71-1.27, P=0.732). The CLBR significantly decreased for women of advanced reproductive age up to 37 years of age (HR, 0.46; 95% CI, 0.39-0.56, P<0.001). The CLBR increased by 63% when more than ten oocytes were retrieved (HR, 1.63; 95% CI, 1.34-1.98, P<0.001). Patients with an AMH level above 32.13pmol/l were likely to have a 72%(HR, 1.72; 95% CI, 1.08-2.73, = 0.023) and 34% (HR, 1.34; 95% CI, 1.07-1.68, P=0.010)improvement in CLBR compared to those with an AMH below 7.85pmol/l and 7.85-32.12pmol/l, respectively. CONCLUSION Despite the higher number of oocytes retrieved in PCOS patients, the reproductive window is not extended for PCOS patients compared with tubal factor infertility patients. Age, AMH and the number of oocytes retrieved play crucial roles in the CLBRs of patients of advanced age (≥35 years).
Collapse
Affiliation(s)
- Yichun Guan
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Yichun Guan,
| | - Pingping Kong
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhiying Xiao
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junyan Zhang
- Training Department, Bothwin Clinical Research Consultants, Redmond, WA, United States
| | - Jingfang He
- Training Department, Bothwin Clinical Research Consultants, Redmond, WA, United States
| | - Wenjun Geng
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfang Yan
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Simin Sun
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingkun Mu
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaofang Du
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xingling Wang
- The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
6
|
Mintziori G, Nigdelis MP, Mathew H, Mousiolis A, Goulis DG, Mantzoros CS. The effect of excess body fat on female and male reproduction. Metabolism 2020; 107:154193. [PMID: 32119876 DOI: 10.1016/j.metabol.2020.154193] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 02/11/2020] [Accepted: 02/27/2020] [Indexed: 02/07/2023]
Abstract
The dramatic increase in the prevalence of obesity coincides with a decline in reproductive health indices in both sexes. Energy excess mediates changes to the regulatory mechanisms of the reproductive system. Obese individuals exhibit increased estrogen concentrations, due to the overexpression of aromatase in the adipose tissue; via a negative feedback loop, men present with symptoms of hypogonadotropic hypogonadism. These hormonal changes, along with increased oxidative stress, lipotoxicity and disturbances in the concentrations of adipokines, directly affect the gonads, peripheral reproductive organs and the embryo. Clinical evidence is somewhat contradicting, with only some studies advocating worse semen parameters, increased incidence of erectile dysfunction, increased doses of ovulation induction medications, and worse live birth rates in assisted reproductive technology (ART) cycles in obese individuals compared with those of normal weight. Similar conclusions are drawn about patients with insulin resistance syndromes, namely polycystic ovary syndrome (PCOS). As far as treatment options are concerned, lifestyle changes, medical therapy and bariatric surgery may improve the reproductive outcome, although the evidence remains inconclusive. In this review, we summarize the evidence on the association of obesity and reproductive health on both the molecular and the clinical level, and the effect of weight-loss interventions on reproductive potential.
Collapse
Affiliation(s)
- Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece.
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Hannah Mathew
- Department of Medicine Boston VA Healthcare System and Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Athanasios Mousiolis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Greece
| | - Christos S Mantzoros
- Department of Medicine Boston VA Healthcare System and Department of Medicine Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
| |
Collapse
|
7
|
Abstract
Infertility is a growing issue for couples. Primary care NPs can manage initial treatment as well as address the emotional and financial burdens of patients experiencing infertility. NPs can provide timely access to investigations and treatment, helping patients achieve their goal of pregnancy sooner.
Collapse
|
8
|
Bahramrezaie M, Amidi F, Aleyasin A, Saremi A, Aghahoseini M, Brenjian S, Khodarahmian M, Pooladi A. Effects of resveratrol on VEGF & HIF1 genes expression in granulosa cells in the angiogenesis pathway and laboratory parameters of polycystic ovary syndrome: a triple-blind randomized clinical trial. J Assist Reprod Genet 2019; 36:1701-1712. [PMID: 31327131 PMCID: PMC6708036 DOI: 10.1007/s10815-019-01461-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 04/26/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Management options for PCOS, as the most prevalent endocrine disorder in women of reproductive age, using natural supplements have a high priority for physicians, especially based on the etiological pathways. Therefore, this study was conducted to describe the effect of resveratrol on the angiogenesis pathway, for management of PCOS through assessing VEGF, HIF1 gene expression, and laboratory parameters. METHODS In this triple-blind RCT, PCOS was confirmed in ICSI candidates based on the Rotterdam criteria. Sixty-two patients that met the inclusion criteria were randomly assigned to two groups. All patients took resveratrol 800 mg/day or placebo for 40 days orally from the beginning of their previous menstruation cycle until the oocyte retrieval day. The serum levels of different hormones were measured, and the expression of HIF1 & VEGF genes was quantified by real-time PCR. RESULTS As for the laboratory hormone assay in 61 PCOS patients, a significant mean difference was seen in the FSH, LH, TSH, and testosterone between the two groups (P < 0.05). The results showed a reduction in the expression of VEGF & HIF1 genes under the effect of resveratrol in the granulosa cells (P = 0.0001). The number of mature oocytes, cleavage rate, fertilization rate, and fertility rate were not significantly different between the two groups (P > 0.05), but the high-quality oocyte rate and high-quality embryo rate were higher in the resveratrol group (P < 0.05). CONCLUSIONS Based on the results, resveratrol may improve some outcomes of PCOS patients, probably through changing the serum levels of some sex hormones and expression of VEGF & HIF1 genes in the angiogenesis pathway of granulosa cells.
Collapse
Affiliation(s)
- Mojdeh Bahramrezaie
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ashraf Aleyasin
- Faculty of Medicine, Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - AboTaleb Saremi
- Sarem Fertility and Infertility Research Center (SAFIR), Sarem Cell Research Center (SCRC), Sarem Women's Hospital, Tehran, Iran
| | - Marzieh Aghahoseini
- Faculty of Medicine, Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Brenjian
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshad Khodarahmian
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Pooladi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
9
|
Delaroche L, Dupont C, Oger P, Aubriot FX, Lamazou F, Yazbeck C. [Polycystic ovary syndrome does not affect blastulation nor cumulative live birth rates]. ACTA ACUST UNITED AC 2019; 47:655-661. [PMID: 31336185 DOI: 10.1016/j.gofs.2019.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Polycystic ovarian syndrome (PCOS) brings complications in the management of the assisted reproductive technology (ART) because of an oocyte quality probably impaired due to modifications of intra- and extra-ovarian factors. Our study aimed to investigate the extended culture in PCOS patients and its influence on the cumulative live birth rates. METHODS Fifty-nine PCOS patients (as defined by the Rotterdam criteria) and 114 normo-ovulatory patients (i.e. with tubal, male or idiopathic infertility, regular cycles and AMH>2ng/mL) aged<37years old who underwent a 1st or 2nd ART attempt with extended culture to day 6 were included from October 2015 to December 2017. The blastulation and cumulative live birth rates were compared between the two groups. RESULTS The PCOS and control patients were 32.22 and 32.91years old respectively (P=0.05). The median number of oocytes retrieved was significantly higher in the PCOS group and the median oocyte maturity rate significantly lower compared with controls. The blastulation rates were similar between the PCOS and the control groups, respectively 57.8% vs. 58.6%, P=0.88. Because of the risks of hyperstimulation syndrome, a freeze all strategy was achieved for 38.9% of PCOS patients vs. 14.0% of the control patients (P<0.01). The cumulative live birth rates were not statistically different: 31.7% in the PCOS group vs. 37.2% in the control group, P=0.50. CONCLUSIONS PCOS was not observed to affect the extended culture nor the cumulative live birth rates in comparison to normo-ovulatory patients, supporting the blastocyst transfer strategy as a suitable option to PCOS patients.
Collapse
Affiliation(s)
- L Delaroche
- Laboratoire Eylau-Unilabs, 55-57, rue Saint-Didier, 75116 Paris, France.
| | - C Dupont
- Inserm équipe lipodystrophies génétiques et acquises, service de biologie de la reproduction-CECOS, Saint-Antoine Research center, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - P Oger
- Centre d'AMP de la clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-sur-Seine, France
| | - F-X Aubriot
- Centre d'AMP de la clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-sur-Seine, France
| | - F Lamazou
- Centre d'AMP de la clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-sur-Seine, France
| | - C Yazbeck
- Centre d'AMP de la clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-sur-Seine, France
| |
Collapse
|
10
|
Li J, Liu X, Hu L, Zhang F, Wang F, Kong H, Dai S, Guo Y. A Slower Age-Related Decline in Treatment Outcomes After the First Ovarian Stimulation for in vitro Fertilization in Women With Polycystic Ovary Syndrome. Front Endocrinol (Lausanne) 2019; 10:834. [PMID: 31866942 PMCID: PMC6906164 DOI: 10.3389/fendo.2019.00834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/14/2019] [Indexed: 01/03/2023] Open
Abstract
Background: Polycystic ovary syndrome (PCOS) patients have a better ovarian reserve and age-related improvement in endocrine disturbances than non-PCOS patients. The effects of age on in vitro fertilization (IVF) treatment outcomes associated with cumulative live birth rate (CLBR) remain unclear. Objectives: To study the effect of age on CLBR after the first ovarian stimulation in IVF in PCOS patients. Method: This retrospective cohort study included 3,502 PCOS patients and 18,596 patients with tubal factor infertility, who underwent their first IVF cycles and subsequent frozen embryo transfer (ET) attempts. The primary outcome was CLBR associated with a single stimulation cycle and secondary outcomes included the implantation rate, clinical pregnancy rate, live birth rate (LBR), large for gestational age (LGA) rate, small for gestational age (SGA) rate, and preterm birth (PTB) rate of fresh ET cycles. Results: PCOS patients over 40 years had a higher implantation rate (27.8 vs. 15.7%, P < 0.05), clinical pregnancy rate (51.4 vs. 26.1%, P < 0.05), LBR (42.3 vs. 18.2%, P < 0.05), and CLBR (50.0 vs. 21.5%, P < 0.05) than non-PCOS patients over 40 years. These rates were comparable between PCOS patients aged 35 to 40 years and those aged over 40 years (P = 0.263, 0.385, and 0.112, respectively). The changes in the implantation rate, clinical pregnancy rate, and CLBR by age were slower for PCOS patients than for non-PCOS patients (all P < 0.05). Among PCOS patients less than 35 years, BMI was negatively associated with CLBR [aOR: 0.961 (0.939-0.985); P < 0.05]; however, among PCOS patients over 35 years, instead of BMI (P = 0.353), age [aOR: 0.891 (0.803-0.990); P < 0.05] and the number of oocytes retrieved [aOR: 1.093 (1.002-1.078); P < 0.05] were significantly associated with CLBR. No significant differences in LGA, LGA, or PTB were detected between PCOS and non-PCOS patients over 35 years (all P > 0.05). Conclusions: The declines in treatment outcomes with age are slower for PCOS patients than for non-PCOS patients. For patients over 40 years, PCOS patients have reproductive advantages over non-PCOS patients. In contrast to younger PCOS patients (<35 years), older PCOS patients (≥35 years) may benefit less from taking time to lose weight before IVF treatment, and the immediate initiation of assisted reproductive treatment is essential.
Collapse
Affiliation(s)
- Jing Li
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaocong Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Linli Hu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fuli Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fang Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huijuan Kong
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shanjun Dai
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yihong Guo
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Yihong Guo
| |
Collapse
|