Department of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China; Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Assisted Reproduction, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
Reprod Biomed Online. 2022 Oct;45(4):745-753. doi: 10.1016/j.rbmo.2022.05.024. Epub 2022 Jun 1.
Does polycystic ovary syndrome (PCOS) affect pregnancy and neonatal outcomes after frozen-thawed embryo transfers (FET) using hormone replacement therapy (HRT) cycles or stimulated cycles?
This was a retrospective cohort study in which singletons born to 1876 women with PCOS and 14,630 women without PCOS under the age of 38 years from 2010 to 2018 were analyzed at a tertiary care academic medical center. The main outcomes were gestational diabetes mellitus (GDM), pregnancy-induced hypertension, preterm premature rupture of membranes (PPROM) and early preterm birth (EPTB).
Women with PCOS showed a higher risk of GDM (adjusted odds ratio [aOR] 1.71, 95% confidence interval [CI] 1.47-1.99), pregnancy-induced hypertension (aOR 1.46, 95% CI 1.13-1.90), PPROM (aOR 1.40, 95% CI 1.02-1.79) and EPTB (aOR 1.51, 95% CI 1.01-2.26) compared with mothers without PCOS. Considering that more PCOS received HRT cycles, subgroup analyses were performed separately for stimulated cycles and HRT cycles. PCOS was not correlated with PPROM and EPTB in the two subgroups. The rate of GDM, pregnancy-induced hypertension and EPTB among women with without PCOS using stimulated cycles appeared to be lower than in women without PCOS using HRT cycles.
Although PCOS indeed confers independent risks for GDM and pregnancy-induced hypertension after FET compared with no PCOS, risks of other adverse outcomes (e.g. PPROM and EPTB) might be exaggerated owing to a higher proportion of HRT cycles used in PCOS.
多囊卵巢综合征（PCOS）是否会影响使用激素替代疗法（HRT）周期或刺激周期的冷冻胚胎移植（FET）后的妊娠和新生儿结局？
这是一项回顾性队列研究，分析了 2010 年至 2018 年在一家三级保健学术医疗中心接受 FET 的 1876 名 PCOS 女性和 14630 名年龄在 38 岁以下的无 PCOS 女性所生育的单胎。主要结局是妊娠期糖尿病（GDM）、妊娠高血压、胎膜早破（PPROM）和早产（EPTB）。
与无 PCOS 的母亲相比，PCOS 女性发生 GDM（调整优势比 [aOR] 1.71，95%置信区间 [CI] 1.47-1.99）、妊娠高血压（aOR 1.46，95% CI 1.13-1.90）、PPROM（aOR 1.40，95% CI 1.02-1.79）和 EPTB（aOR 1.51，95% CI 1.01-2.26）的风险更高。考虑到更多的 PCOS 接受了 HRT 周期，因此分别对刺激周期和 HRT 周期进行了亚组分析。在这两个亚组中，PCOS 与 PPROM 和 EPTB 均无相关性。无 PCOS 女性使用刺激周期的 GDM、妊娠高血压和 EPTB 发生率似乎低于无 PCOS 女性使用 HRT 周期。
尽管与无 PCOS 相比，PCOS 确实会增加 FET 后 GDM 和妊娠高血压的独立风险，但由于 PCOS 中使用 HRT 周期的比例较高，其他不良结局（如 PPROM 和 EPTB）的风险可能被夸大。
