Center for Reproductive Medicine, Shandong University, Jinan, China.
Shandong Provincial Clinical Medicine Research Center for Reproductive Health, Shandong University, Jinan, China.
Front Endocrinol (Lausanne). 2022 Jun 3;13:889029. doi: 10.3389/fendo.2022.889029. eCollection 2022.
This study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes and adverse perinatal outcomes, comparing the characteristics, ovarian response, and assisted reproductive outcomes in patients with various PCOS phenotypes after fertilization (IVF)/intracytoplasmic sperm injection (ICSI).
This study comprised 6,732 patients who underwent the first cycle of IVF/ICSI treatment in our outpatient department from January 2017 to July 2018. Propensity score matching (PSM) was used in PCOS and non-PCOS groups to balance the influence of intergroup confounding factors. After the PSM procedure, 1,186 patients were included in the two groups, and the PCOS patients were further divided into four PCOS phenotype groups based on the Rotterdam criteria.
Patients with various PCOS phenotypes had similar rates of biochemical pregnancy, clinical pregnancy, and live birth (all -values > 0.05). The overall incidence of adverse pregnancy outcomes (including ectopic pregnancy, miscarriage, preterm birth) was significantly higher in PCOS phenotype A and D groups than in the control group (44% and 46.4% vs. 28.7%, = 0.027). The rates of hypertensive disorder of pregnancy (HDP) were significantly higher in PCOS phenotype A and C groups than in the control group (9.3% and 12.5% vs. 3.1%, = 0.037). After adjustment for potential confounders, the differences in adverse pregnancy outcomes persisted ( = 0.025).
The overall incidence of adverse pregnancy outcomes is higher in women with PCOS phenotypes A and D than in women with non-PCOS.
本研究旨在评估多囊卵巢综合征（PCOS）表型与不良围产结局之间的关系，比较不同 PCOS 表型患者受精（IVF）/卵胞浆内单精子注射（ICSI）后特征、卵巢反应和辅助生殖结局。
本研究纳入了 2017 年 1 月至 2018 年 7 月在我院门诊行首次 IVF/ICSI 治疗的 6732 例患者。采用倾向评分匹配（PSM）法平衡组间混杂因素的影响，在 PSM 后，共有 1186 例患者纳入两组，根据 Rotterdam 标准，PCOS 患者进一步分为 4 种 PCOS 表型组。
具有不同 PCOS 表型的患者生化妊娠、临床妊娠和活产率相似（均 P>0.05）。PCOS 表型 A 和 D 组的不良妊娠结局（包括异位妊娠、流产、早产）总发生率明显高于对照组（44%和 46.4%比 28.7%， P=0.027）。PCOS 表型 A 和 C 组的妊娠高血压疾病（HDP）发生率明显高于对照组（9.3%和 12.5%比 3.1%， P=0.037）。调整潜在混杂因素后，不良妊娠结局的差异仍然存在（ P=0.025）。
与非 PCOS 患者相比，PCOS 表型 A 和 D 患者的不良妊娠结局总发生率更高。
