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Kugelman N, Digby A, Rotshenker-Olshinka K, Bellemare V, Pooni A, Son WY, Dahan MH. Basal serum luteinizing hormone, total testosterone, and free testosterone levels do not impact IVF outcomes in patients with polycystic ovary syndrome. J Turk Ger Gynecol Assoc 2024; 25:192-199. [PMID: 39658861 PMCID: PMC11632639 DOI: 10.4274/jtgga.galenos.2024.2024-2-9] [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: 07/16/2024] [Accepted: 10/11/2024] [Indexed: 12/12/2024] Open
Abstract
Objective To assess the influence of basal serum levels of luteinizing hormone (LH), total testosterone (TT), and free testosterone (FT) on in vitro fertilization (IVF) success rates in patients with polycystic ovary syndrome (PCOS). Material and Methods A retrospective cohort analysis of PCOS patients who underwent freeze-all, gonadotropin releasing hormone (GnRH) antagonist IVF protocols from January 2013 to December 2019. Patients were grouped based on median basal serum levels of LH, TT, and FT to compare their IVF outcomes. Results A total of 76 women with PCOS diagnosed as per the 2003 Rotterdam criteria were included. When analyzed by LH levels, groups had similar baseline characteristics except for higher mean ± standard deviation TT (1.4±0.9 vs. 1.9±0.9 nmol/L, p=0.02) and FT (0.6±0.5 vs. 0.9±0.5 nmol/L, p=0.03) in the elevated LH group. However, clinical pregnancy rates (CPR) (34.2% vs. 44.7%, p=0.35) and live birth rates (LBR) (21.0% vs. 31.6%, p=0.29) were not different. The group with lower TT had more previous pregnancies (0.9±1.2 vs. 0.3±0.7, p=0.02) and shorter infertility duration (2.3±2.0 vs. 3.7±2.7 years, p=0.04), but again CPR (46.8% vs. 42.8%, p=0.90) and LBR (37.5% vs. 25.7%, p=0.33) were similar. FT analysis revealed no significant differences in CPR (48.2% vs. 36.7%, p=0.36) and LBR (23.2% vs. 37.9%, p=0.22) despite higher TT (1.1±0.4 vs. 2.2±1.1 nmol/L, p<0.001) and LH (6.1±3.8 vs. 11.2±7.2 IU/L, p<0.001) in the high FT group. Conclusion Basal serum levels of LH, TT, and FT did not significantly affect IVF outcomes in patients with PCOS using GnRH antagonist, freeze-all protocols.
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Affiliation(s)
- Nir Kugelman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Alyson Digby
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
| | - Keren Rotshenker-Olshinka
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
- Department of Obstetrics and Gynecology, Hebrew University, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Véronique Bellemare
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
| | - Amrita Pooni
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
| | - Weon-Young Son
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada
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Raad Helmi Z, Nori W, Ghani Zghair MA. The Value IRS-1 rs1801278G > A Polymorphism Testing in Evaluating
Infertile Women with Polycystic Ovarian Syndrome: A Case-control
Study. CURRENT WOMEN S HEALTH REVIEWS 2024; 20. [DOI: 10.2174/1573404820666230906091306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 07/05/2023] [Accepted: 07/21/2023] [Indexed: 01/16/2025]
Abstract
Background:
Polycystic ovary syndrome (PCOS) is a leading cause of infertility. Insulin
resistance is a key element in pathogenesis. The insulin receptor causes phosphorylation of the insulin
receptor substrate (IRS); IRS-1 rs1801278G > A polymorphism variant is the most common genetic
variant associated with IR and PCOS.
Objective:
We aimed to examine the frequency of IRS-1 rs1801278G > A polymorphism variant and
test its value in evaluating infertile PCOS women.
Methods:
A case-control study recruited 140 age and body-mass-matched participants in the university
hospital, subdivided according to Rotterdam criteria into PCOS cases (70/140) and healthy controls
(70/140). We collected demographic data, ultrasonic [antral follicles and endometrial thickness], hormonal
[FSH, LH, AMH, E2], and genetic data by polymerase chain reaction for analysis.
Result:
Wild GG SNP rs1801278 G was meaningfully higher among controls (58.57%, P<0.0001).
Mutant AA SNP rs1801278 was significantly higher in PCOS women (37.14%, P-value =0.0001, an
odds ratio of 20.50, 95% CI (9.42-28.63) to develop PCOS. Heterogenous GA gene SNP rs1801278
showed a trend of higher frequency in PCOS patients with 44.29%; OR of 3.91, 95% CI (1.37–7.55);
P = 0.422. Upon correlating infertility parameters to SNP rs1801278 G>A polymorphism, statistical
differences were found with AFC, LH/FSH ratio, and serum testosterone. As for the AMH, E2, and
endometrial thickness, they failed to have a statistical value.
Conclusion:
The significant correlation of genetic polymorphism to infertility parameters among
PCOS women opens a new therapeutic and prognostic avenue that helps gynecologists tailor manganate
for a better and safer outcome.
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Affiliation(s)
- Zeena Raad Helmi
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Wassan Nori
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiriyah University, Baghdad, Iraq
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Thabet M, Abdelhafez MS, Elshamy MR, Albahlol IA, Fayala E, Wageeh A, El-Zayadi AA, Bahgat NA, Mohammed SM, Mohamed AA, Awad MM, El-Menayyer A, El-Sherbiny M, Elsherbini DMA, Albarakati RG, Alshaikh ABA, Edris FE, Bushaqer NJ, Salama YGM, Abdel-razik MM. Competence of Combined Low Dose of Human Chorionic Gonadotropin (HCG) and Clomiphene Citrate (CC) Versus Continued CC during Ovulation Induction in Women with CC-Resistant Polycystic Ovarian Syndrome: A Randomized Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1300. [PMID: 39202581 PMCID: PMC11356540 DOI: 10.3390/medicina60081300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 07/31/2024] [Accepted: 08/09/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Polycystic ovarian syndrome (PCOS) is a widespread endocrine disorder affecting 5-18% of females in their childbearing age. The aim of this study is to assess the efficacy of combining a low dosage of human chorionic gonadotropin (HCG) along with clomiphene citrate (CC) for stimulating ovulation in infertile women diagnosed with CC-resistant PCOS. Materials and Methods: A randomized controlled trial was carried out on 300 infertile CC-resistant PCOS women. All participants were assigned to two groups: the CC-HCG group and the CC-Placebo group. Subjects in the CC-HCG group were given CC (150 mg/day for 5 days starting on the 2nd day of the cycle) and HCG (200 IU/day SC starting on the 7th day of the cycle). Subjects in the CC-Placebo group were given CC and a placebo. The number of ovarian follicles > 18 mm, cycle cancellation rate, endometrial thickness, ovulation rate, clinical pregnancy rate, and occurrence of early ovarian hyper-stimulation syndrome were all outcome variables in the primary research. Results: Data from 138 individuals in the CC-HCG group and 131 participants in the CC-Placebo group were subjected to final analysis. In comparison to the CC-Placebo group, the cycle cancellation rate in the CC-HCG group was considerably lower. The CC-HCG group exhibited a substantial increase in ovarian follicles reaching > 18 mm, endometrial thickness, and ovulation rate. The clinical pregnancy rate was higher in the CC-HCG group (7.2% vs. 2.3%; CC-HCG vs. CC-Placebo). Upon adjusting for BMI and age, the findings of our study revealed that individuals in the CC-HCG group who had serum prolactin levels below 20 (ng/mL), secondary infertility, infertility duration less than 4 years, baseline LH/FSH ratios below 1.5, and serum AMH levels more than 4 (ng/mL) had a higher likelihood of achieving pregnancy. In the CC-Placebo group, there was a greater prediction of clinical pregnancy for those with serum AMH (<4), primary infertility, serum prolactin ≤ 20 (ng/mL), baseline LH/FSH < 1.5, and infertility duration < 4 years. Conclusions: The use of a small dose of HCG along with CC appeared to be an effective treatment in reducing cycle cancelation, improving the clinical pregnancy rate and ovulation rate in CC-resistant PCOS patients. The trial was registered with Clinical Trials.gov, identifier NCT02436226.
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Affiliation(s)
- Mahmoud Thabet
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Mohamed Sayed Abdelhafez
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Maged Ragheb Elshamy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Ibrahim A. Albahlol
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
- Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Emad Fayala
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Alaa Wageeh
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Ahmed Abdelhamid El-Zayadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Nagwan Ahmed Bahgat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Shereen M. Mohammed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Alhussein Ahmed Mohamed
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Mahmoud Mohamed Awad
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Ahmed El-Menayyer
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
| | - Mohamed El-Sherbiny
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia;
- Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | | | - Rayan G. Albarakati
- Department of Clinical Medical Sciences, College of Medicine, AlMaarefa University, P.O. Box 71666, Riyadh 11597, Saudi Arabia;
| | - Ahmed Baker A. Alshaikh
- Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka 72388, Saudi Arabia;
| | - Fawaz E. Edris
- Department of Obstetrics and Gynecology, College of Medicine, Umm AlQura University, Makkah 24382, Saudi Arabia;
| | - Nayla Jamal Bushaqer
- Bahrain Defence Force (BDF) Hospital, Riffa P.O. Box 28743, Bahrain; (N.J.B.); (Y.G.M.S.)
| | | | - Mahmoud Mohamed Abdel-razik
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura 35111, Egypt; (M.T.); (M.S.A.); (M.R.E.); (I.A.A.); (E.F.); (A.W.); (A.A.E.-Z.); (N.A.B.); (S.M.M.); (A.A.M.); (M.M.A.); (A.E.-M.); (M.M.A.-r.)
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Kugelman N, Pooni A, Rotshenker-Olshinka K, Bellemare V, Digby A, Dahan MH. Impact of stimulation with luteinizing hormone activity on IVF outcomes in patients with polycystic ovary syndrome. J Turk Ger Gynecol Assoc 2024; 25:60-65. [PMID: 38867686 DOI: 10.4274/jtgga.galenos.2024.2023-12-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024] Open
Abstract
Objective To compare in-vitro fertilization (IVF) outcomes in polycystic ovary syndrome (PCOS) patients treated with follicle stimulating hormone (FSH) alone or FSH and luteinizing hormone (LH), under freeze-all gonadotropin-releasing hormone (GnRH) antagonist protocols. Material and Methods This retrospective study at a university center included PCOS patients, who underwent freeze-all GnRH antagonist IVF cycles between January 2013 and December 2019. They were divided into FSH-only and FSH + LH groups, focusing on pregnancy and live birth rates. Results The study included 82 patients: 43 received FSH + LH and 39 FSH only. Baseline characteristics were similar, except for higher thyroid stimulating hormone levels in the FSH-only group. The FSH + LH group required a lower mean ± standard deviation total dose of FSH (1271.5±376.7 vs. 1407.2±645.3 IU, p=0.02), had a shorter mean cycle length (7.3±3.4 vs. 8.3±1.6 days, p=0.004), and had a higher mean number of follicles stimulated (36.9±15.9 vs. 35.9±9.7, p=0.008) compared to the FSH-only group. No significant differences in pregnancy and live birth rates were noted at first transfer, but the cumulative live birth rate was significantly higher in the FSH-only group [30 of 39 (76.9%) vs. 24 of 43 (55.8%), p=0.044]. Conclusion LH supplementation in PCOS patients undergoing GnRH antagonist IVF protocols may impair cumulative live birth rates, despite lowering FSH requirement and reducing IVF cycle length. These results highlight the complex role of LH in IVF outcomes for PCOS patients, suggesting a need for further large studies to fully understand the impact of LH in such treatments.
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Affiliation(s)
- Nir Kugelman
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Amrita Pooni
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
| | - Keren Rotshenker-Olshinka
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Véronique Bellemare
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
| | - Alyson Digby
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
| | - Michael H Dahan
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University Faculty of Medicine, Montreal, Canada
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Gao J, Mai Q, Zhong Y, Miao B, Chen M, Luo L, Zhou C, Mol BW, Yanwen X. Pretreatment with oral contraceptive pills in women with PCOS scheduled for IVF: a randomized clinical trial. Hum Reprod Open 2024; 2024:hoae019. [PMID: 39697220 PMCID: PMC11653855 DOI: 10.1093/hropen/hoae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/18/2024] [Indexed: 12/20/2024] Open
Abstract
STUDY QUESTION What is the effect of pretreatment with oral contraceptive pills (OCPs) on oocyte and embryo quality and pregnancy rates in women with polycystic ovary syndrome (PCOS) scheduled for IVF/ICSI cycles? SUMMARY ANSWER In women with PCOS who underwent a first or second IVF/ICSI cycle with a GnRH antagonist protocol and were randomized to start ovarian stimulation immediately, the quality of cleavage-stage embryos was non-inferior to pretreatment with OCP. WHAT IS KNOWN ALREADY PCOS in Asian populations is characterized by high levels of circulating LH in the early follicular phase. Previous studies indicated that inappropriately high LH levels might affect oocyte maturation and fertilization rates, and impaired embryo quality, consequently resulting in higher rates of impaired pregnancy and miscarriage in women with PCOS. OCPs are frequently used as pretreatment to lower LH levels in PCOS patients. STUDY DESIGN SIZE DURATION We performed a randomized controlled trial. After informed consent, women diagnosed with PCOS scheduled for their first or second IVF/ICSI cycle with a GnRH antagonist protocol were randomized to receive OCPs (OCP group) or start ovarian stimulation immediately, regardless of the day of the menstrual cycle (non-OCP group). Using a non-inferiority hypothesis, the sample size was calculated at 242 women. The study lasted from 7 February 2018 to 31 August 2021. PARTICIPANTS/MATERIALS SETTING METHODS A total of 242 infertility patients with PCOS undergoing the first or second cycle of IVF or ICSI were enrolled and randomized into two groups. In the OCP group, recombinant FSH was started on Day 7 of the washout period after pretreatment with OCP. In the non-OCP group, recombinant FSH was started immediately regardless of the day of the menstrual cycle. All participants received standardized GnRH antagonist ovarian stimulation. The freeze-all strategy was applied to all participants. The primary outcome was the number of good-quality embryos on Day 3 after insemination. Secondary outcomes included the rates of blastocyst formation, implantation, clinical pregnancy, and live birth from the first frozen/warmed embryo transfer cycles and cumulative live birth rates. MAIN RESULTS AND THE ROLE OF CHANCE We randomized 242 women to receive OCP (n = 121) or start immediately with ovarian stimulation (n = 121). The number of good-quality embryos on Day 3 in the OCP group was non-inferior to the non-OCP group (OCP group versus non-OCP group, 6.58 ± 4.93 versus 7.18 ± 4.39, AD -0.61, 95% CI: -1.86 to 0.65, P = 0.34). The rates of blastocyst formation (55.4% versus 52.9%, relative risk (RR) 1.11, 95% CI: 0.96 to 1.28, P = 0.17), implantation (63.0% versus 65.5%, RR 0.90, 95% CI: 0.53 to 1.53, P = 0.79), clinical pregnancy (67.9% versus 68.8%, RR 0.96, 95% CI: 0.54 to 1.71, P = 1.0), and live birth rate (52.8% versus 55.1%, RR 0.92, 95% CI: 0.53 to 1.56, P = 0.79) of the first frozen/warmed embryo transfer cycles were all comparable between the OCP and non-OCP group, respectively. Cumulative live birth rates were also similar in the OCP and non-OCP groups (78.3% versus 83.5%, respectively RR 0.71, 95% CI: 0.36 to 1.42, P = 0.39). LIMITATIONS REASONS FOR CAUTION Only patients with PCOS in Southern China were recruited. Therefore, caution is necessary when generalizing our results to all such patients with PCOS. Also, since a freeze-only strategy was used, the results of this study are only applicable when infertile women with PCOS undergo the freeze-only method. The obvious treatment difference between the two groups meant that the study was designed as an open-label study for women and doctors. The study had a randomized controlled design that minimized bias. WIDER IMPLICATIONS OF THE FINDINGS Pretreatment with OCPs to lower LH levels in patients with PCOS before ovarian stimulation in IVF or ICSI cycles may not improve the quality of cleavage-stage embryos. STUDY FUNDING/COMPETING INTERESTS This study was funded by the National Key Research and Development Program of China (No. 2023YFC2705503). This study was supported in part by the Investigator-Initiated Studies Program (grant from MSD and Organon). BWM reports consultancy, travel support, and research funding from Merck. He reports consultancy from Organon and Norgine, and also reports holding stock from ObsEva. No conflicts of interest are declared for the other authors. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (No. chiCTR1800014822). URL: https://www.chictr.org.cn/showproj.html?proj=25280. TRIAL REGISTRATION DATE 7 February 2018. DATE OF FIRST PATIENT’S ENROLLMENT 22 February 2018.
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Affiliation(s)
- Jun Gao
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Qingyun Mai
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Yiping Zhong
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Benyu Miao
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Minghui Chen
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Lu Luo
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Canquan Zhou
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, The Ritchie Center, Monash
University, Clayton, VIC, Australia
- Aberdeen Centre for Women’s Health Research, Institute of Applied Health
Sciences, School of Medicine, Medical Sciences and Nutrition, University of
Aberdeen, Aberdeen, UK
| | - Xu Yanwen
- Department of Obstetrics and Gynaecology, Reproductive Medicine Center, The
First Affiliated Hospital, Sun Yat-Sen University, Guangzhou,China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, The First
Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Department of Obstetrics and Gynaecology, Guangdong Provincial Clinical
Research Center for Obstetrical and Gynecological Diseases, The First Affiliated
Hospital, Sun Yat-Sen University, Guangzhou,China
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Liu S, Zhou X, Jie H, Zheng Z, Cai B, Mai Q, Zhou C. Higher Cumulative Live Birth Rate but Also Higher Late Miscarriage Risk in Non-Obese Women with Polycystic Ovary Syndrome Undergoing the First IVF/ICSI Cycle. Int J Womens Health 2024; 16:289-298. [PMID: 38415060 PMCID: PMC10898478 DOI: 10.2147/ijwh.s445021] [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: 10/27/2023] [Accepted: 01/22/2024] [Indexed: 02/29/2024] Open
Abstract
Purpose To determine the impact of polycystic ovary syndrome on in vitro fertilization/intracytoplasmic sperm injection and embryo transfer outcomes while analyzing the influencing factors. Patients and Methods A retrospective cohort study comprised 4839 patients who underwent their first cycle of IVF/ICSI treatment from January 2016 to December 2021. Cumulative pregnancy rates, cumulative live birth rates, and late miscarriage rates compared between the PCOS group and control group. Subgroup analysis and binary regression were used to analyze the influence of BMI on clinical outcomes among individuals diagnosed with PCOS. Results Non-obese PCOS patients exhibited higher cumulative pregnancy rates, cumulative live birth rates, and late miscarriage rates compared to the control group with the normal BMI population (84.7% vs71.2%, P < 0.001; 74.1% vs 61.6%, P < 0.001; 4.1% vs 2.0%, P = 0.002), but there was no significant difference in early miscarriage rates between the two groups. Conclusion Non-obese PCOS patients demonstrated a notably higher cumulative live birth rate but also a higher risk of late miscarriage compared to non-PCOS females with a normal BMI.
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Affiliation(s)
- Simin Liu
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
| | - Xiu Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
| | - Huiying Jie
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
| | - Zetong Zheng
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
| | - Bing Cai
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
| | - Qingyun Mai
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou, People's Republic of China
| | - Canquan Zhou
- Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
- Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, People's Republic of China
- Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou, People's Republic of China
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Liu Z, Wang KH. Effect of basal luteinizing hormone (bLH) level on in vitro fertilization/intra-cytoplasmic injections (IVF/ICSI) outcomes in polycystic ovarian syndrome (PCOS) patients. BMC Pregnancy Childbirth 2023; 23:618. [PMID: 37644399 PMCID: PMC10466855 DOI: 10.1186/s12884-023-05944-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To evaluate the effect of basal luteinizing hormone (bLH) levels on In Vitro Fertilization/Intra-Cytoplasmic Injections (IVF/ICSI) outcomes in polycystic ovary syndrome (PCOS). METHODS A total of 256 PCOS patients who underwent IVF/ICSI treatment in our center from January 2018 to January 2022 were analyzed retrospectively. The patients were based on the third quartile (12.455) of the basal LH value was taken as the cut-off value and was divided into high and low LH group: high LH group (LH ≥ 12.455 IU / L) and low LH group (LH < 12.455 IU / L) and the OC group was pretreated with oral contraceptives. The outcomes in ovulation induction and embryo transfer cycles of the three groups were then compared. In addition, factors influencing the number of good quality embryos and the early onset LH peak were analyzed. RESULTS Ages, infertility duration, body mass index (BMI), and basal follicle-stimulating hormone (FSH), and progesterone (P), testosterone (T) levels were not significantly different among the three groups (p > 0.05). However,there were significant differences in basal LH and basal E2 between low LH group and high LH group, and there were significant differences in basal LH between high LH group and OC group (p < 0.05). LH on the antagonist day was significantly different between low LH group and high LH group and between high LH group and OC group (p < 0.05). LH on the hCG (human Chorionic Gonadotropin) day there were significant differences between low LH group and OC group, high LH group and OC group (p < 0.05). The Mode of triggering between the three groups had significant differences between the two groups (p < 0.05). In addition, the number of days from gonadotropin (Gn) initiation to antagonist addition were significantly different among the three groups (p < 0.05). In addition, total Gn doses,the number of oocytes retrieved, the number of Gn days, 2pronucleus (2PN) numbers, number of good quality embryos, and number of high risk OHSS (Ovarian Hyper-stimulation Syndrome), cases with OHSS occurrences were not significantly different among the three groups (p > 0.05). Moreover, the cycle and clinical pregnancy outcomes and the cumulative clinical pregnancy rate and the cumulative live birth rate were not significantly different among the three groups (p > 0.05). LH levels on the day of antagonist addition affected the number of good-quality embryos (B < 0, p < 0.05). However, LH levels on the day antagonist was added were not significantly correlated with basal LH levels (Pearson correlation coefficient = 0.259), the ROC curve was constructed for the logistic prediction model of the early onset LH peak, and the AUC value was 0.747, indicating that the logistic combined model we constructed had a good ability to predict the early onset LH peak. CONCLUSION Basal LH levels do not affect the pregnancy outcomes in PCOS patients after antagonist protocols. Besides, LH levels on the day of antagonist addition affect the number of good quality embryos for PCOS patients undergoing IVF /ICSI.
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Affiliation(s)
- Zhuo Liu
- The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Ke-Hua Wang
- Reproduction and Genetics Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
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Fang Y, He Y, Wang W, Zhang Z, Zhou P, Cao Y, He X, Xu Y, Wei Z. Influencing factors and predictive model of live birth involving low-grade blastocyst frozen-thawed transfer: a retrospective study. Eur J Med Res 2023; 28:117. [PMID: 36907957 PMCID: PMC10009939 DOI: 10.1186/s40001-023-01045-2] [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: 10/18/2022] [Accepted: 02/06/2023] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Whether only low-grade blastocysts should undergo freeze-thaw transfer during the in vitro fertilization/intracytoplasmic sperm injection cycle remains controversial; however, high-quality embryos cannot be obtained from some patients. Therefore, we aimed to identify factors that may affect the live birth. METHODS A total of 662 couples with only low-grade blastocysts who voluntarily accepted freeze-thaw blastocyst transfer at a single reproductive center over a 7-year period were followed-up. According to the outcome after transfer, they were divided into live birth group and failed pregnancy group. A nomogram was constructed for predicting live births. RESULTS Baseline information and clinical treatment characteristics of patients in the two groups were comparable. Fifty-two of the 662 cycles (7.9%) resulted in live birth. Paternal age, maternal basal luteinizing hormone level, endometrial preparation scheme, and blastocyst development days were independent factors that affected low-grade blastocyst freeze-thaw transfer outcomes. The predictive model constructed based on these four factors presented favorable calibration and discriminatory abilities (area under the curve, 0.734; 95% confidence interval, 0.781-0.813). CONCLUSIONS For patients who exclusively underwent low-grade blastocyst freeze-thaw transfer, advanced paternal age and a high level of maternal basal luteinizing hormone adversely affected low-grade blastocyst freeze-thaw transfer outcomes. Artificial cycle preparation of the endometrium and day 5 blastocyst selection may improve the probability of live birth.
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Affiliation(s)
- Yuan Fang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ye He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wanlu Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhiguo Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ping Zhou
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yunxia Cao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xiaojin He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuping Xu
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China.,Anhui Province Key Laboratory of Reproductive Health and Genetics, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Engineering Research Center of Biopreservation and Artificial Organs, No. 81 Meishan Road, Hefei, 230032, Anhui, China.,Anhui Provincial Institute of Translational Medicine, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Zhaolian Wei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, Anhui, China. .,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University), No. 81 Meishan Road, Hefei, 230032, Anhui, China. .,Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
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9
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Luo X, Deng B, Li L, Ma R, Mai X, Wu Z. LH level on ovulation trigger day has a different impact on the outcomes of agonist and antagonist regimens during in vitro fertilization. J Ovarian Res 2023; 16:26. [PMID: 36707867 PMCID: PMC9883898 DOI: 10.1186/s13048-023-01110-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND To assess the impact of the luteinizing hormone level on ovulation trigger day (LHOTD) on in vitro fertilization (IVF) outcomes in gonadotropin-releasing hormone (GnRH) agonist and antagonist regimens during fresh embryo transfer cycles. METHODS A stepwise, progressive multivariate regression model was introduced to assess the effect of the LHOTD on clinical pregnancy and live birth rates. Mantel‒Haenszel stratification analysis was used to examine the association between the LHOTD and clinical outcomes with the antagonist regimen. RESULTS The LHOTD had different distributions in the agonist and antagonist regimens. The cycles were assigned into three LHOTD tertile groups. In the agonist regimen, compared with the 1st tertile (T1), in the 2nd (T2) and 3rd (T3) tertiles, the adjusted odds ratios (ORs) (95% confidence intervals [CIs], P value) were 1.187 (1.047-1.345, 0.007) and 1.420 (1.252-1.610, < 0.001) for clinical pregnancy, respectively, and 1.149 (1.009-1.309, 0.036) and 1.476 (1.296-1.681, < 0.001) for live birth. In the antagonist regimen, there was no significant difference in clinical pregnancy and live birth rates among the tertiles. However, in the stratified group of patients aged less than 35 years, the ORs (95% CIs, P value) of T2 and T3 were 1.316 (1.051-1.648, 0.017) and 1.354 (1.077-1.703, 0.009) for clinical pregnancy, respectively, and 1.275 (1.008-1.611, 0.043) and1.269 (0.999-1.611, 0.051) for live birth. Moreover, there was a discrepancy in the results among the subdivided LHOTD T1 groups adopting the antagonist regimen. Compared with that of the < 1.06 mIU/mL subgroup, the ORs (95% CIs, P value) of the > 1.5 mIU/mL subgroup were 1.693 (1.194-2.400, 0.003) for clinical pregnancy and 1.532 (1.057-2.220, 0.024) for live birth after eliminating potential confounders. CONCLUSIONS The LHOTD was profoundly suppressed in the agonist regimen, and its level was positively correlated with clinical pregnancy and live birth rates. In contrast, in the flexible antagonist regimen, the LHOTD was significantly higher than that in the agonist regimen and did not correlate with the outcome, except for women in the nonadvanced age group and those with an excessively suppressed LHOTD. Further investigation is required to determine the rationale for these findings.
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Affiliation(s)
- Xi Luo
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China ,grid.218292.20000 0000 8571 108XFaculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China ,grid.218292.20000 0000 8571 108XMedical School, Kunming University of Science and Technology, Kunming, China
| | - Bo Deng
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Lei Li
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Rui Ma
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Xuancheng Mai
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
| | - Ze Wu
- grid.414918.1Department of Reproductive Medicine, The First People’s Hospital of Yunnan Province, Kunming, China ,grid.218292.20000 0000 8571 108XReproductive Medical Center of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China ,NHC Key Laboratory of Periconception Health Birth in Western China, Kunming, China
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10
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Ni Z, Mei S, You S, Lin Y, Cheng W, Zhou L, Kuang Y, Yu C. Adverse Effects of Polycystic Ovarian Syndrome on Pregnancy Outcomes in Women With Frozen-Thawed Embryo Transfer: Propensity Score-Matched Study. Front Endocrinol (Lausanne) 2022; 13:878853. [PMID: 35733779 PMCID: PMC9207193 DOI: 10.3389/fendo.2022.878853] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This work aimed to evaluate the adverse effect of polycystic ovary syndrome (PCOS) on pregnancy outcomes of singletons after vitrification in women with frozen-thawed embryo transfer (FET). METHODS Patients with/without PCOS who underwent FET from January 2013 and December 2018 were included. Propensity score matching (PSM) was used to reduce the influence of bias. Logistic regression was applied to identify the risk factors of adverse pregnancy outcomes of singletons in women with PCOS. RESULT After PSM, the PCOS group had shorter gestational age (P<0.001) and lower newborn birth weight than the non-PCOS group (P=0.045). Compared with the non-PCOS group, the PCOS group had an increased risk of gestational diabetes mellitus (GDM) and pregnancy-induced hypertension (PIH) (P<0.001), placenta and membrane abnormality (P<0.001), stillbirth (P<0.001), neonatal complication (P=0.014), and miscarriage rate (P<0.001). Neonatal complication was associated with parity (adjusted OR=1.202, 95% CI=1.002-1.443, P=0.048) and basal P level (adjusted OR=1.211, 95% CI=1.021-1.436, P=0.028). According to multivariable logistic regression analysis, the miscarriage rate was related to parity (adjusted OR=1.201, 95% CI=1.057-1.166, P=0.005) and basal E2 (adjusted OR=1.002, 95% CI=1.000-1.004, P=0.019) and P levels on the day of embryo transfer (adjusted OR=0.971, 95% CI=0.957-0.985, P<0.001). CONCLUSIONS Compared with non-PCOS women, women with PCOS have a higher risk of GDM and PIH, and neonatal complications and therefore require additional care during pregnancy and parturition.
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Affiliation(s)
- Zhexin Ni
- Department of Traditional Chinese Medicine Gynecology, Changhai Hospital, Shanghai, China
| | - Shanshan Mei
- Department of Traditional Chinese Medicine Gynecology, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Siting You
- Central Laboratory, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yi Lin
- Department of Traditional Chinese Medicine, Naval Medical University, Shanghai, China
| | - Wen Cheng
- Department of Traditional Chinese Medicine Gynecology, Changhai Hospital, Shanghai, China
| | - Ling Zhou
- Department of Traditional Chinese Medicine Gynecology, Changhai Hospital, Shanghai, China
| | - Yanping Kuang
- Department of Assisted Reproductive Medicine, Shanghai Ninth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Chaoqin Yu, ; Yanping Kuang,
| | - Chaoqin Yu
- Department of Traditional Chinese Medicine Gynecology, Changhai Hospital, Shanghai, China
- Department of Traditional Chinese Medicine Gynecology, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Chaoqin Yu, ; Yanping Kuang,
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11
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Sookaromdee P, Wiwanitkit V. Do Basal Luteinizing Hormone and Luteinizing Hormone/Follicle- Stimulating Hormone Ratio have Significance in Prognosticating the Outcome of In vitro Fertilization Cycles in Polycystic Ovary Syndrome? J Hum Reprod Sci 2021; 14:325. [PMID: 34759626 PMCID: PMC8527084 DOI: 10.4103/jhrs.jhrs_87_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/20/2021] [Accepted: 08/02/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India
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12
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Neeta S, Neha M, Yogita D. Do Basal Luteinizing Hormone and Luteinizing Hormone/ Follicle-Stimulating Hormone Ratio have Significance in Prognosticating the Outcome of In vitro Fertilization Cycles in Polycystic Ovary Syndrome? J Hum Reprod Sci 2021; 14:326. [PMID: 34759627 PMCID: PMC8527067 DOI: 10.4103/jhrs.jhrs_105_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/08/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Singh Neeta
- Department of Obstetrics and Gynaecology, ART Center, All India Institute of Medical Sciences, New Delhi, India
| | - Mishra Neha
- Department of Obstetrics and Gynaecology, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Dogra Yogita
- Department of Obstetrics and Gynaecology, ART Center, All India Institute of Medical Sciences, New Delhi, India
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