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多囊卵巢综合征表型 A 和 D 的女性进行冻融胚胎移植后流产风险增加。

Increased risk of abortion after frozen-thawed embryo transfer in women with polycystic ovary syndrome phenotypes A and D.

机构信息

Center for Reproductive Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, China.

Key Laboratory of Reproductive Endocrinology of Ministry of Education, Shandong University, Jinan, 250012, Shandong, China.

出版信息

Sci Rep. 2022 Sep 1;12(1):14852. doi: 10.1038/s41598-022-18704-9.

Abstract

Polycystic ovary syndrome (PCOS) is associated with adverse pregnancy outcomes, including an increased risk of abortion, premature delivery, and even neonatal outcomes. After removing the effect of COH on patients, studying the pregnancy outcomes of patients with different PCOS phenotypes after FET may better reflect the impact of different PCOS phenotypes on ART outcomes. Data of 8903 patients who underwent FET between January 2017 and October 2019 were retrospectively collected and evaluated. All patients were divided into a control group and four phenotype groups based on Rotterdam criteria. The main outcomes were pregnancy outcomes after FET. We found significantly higher abortion (P = 0.010) and lower ongoing pregnancy (P = 0.023) rates for women with PCOS phenotypes A and D compared to those in the control group. After adjusting for potential confounders, PCOS phenotypes A and D were associated with an elevated risk of abortion (adjusted OR, 1.476, P = 0.016; adjusted OR, 1.348, P = 0.008, respectively). The results of this study suggest that when performing FET, clinicians should individually manage women with PCOS phenotypes A and D to reduce the rate of abortion and increase the rate of LB, and achieve better pregnancy outcomes.

摘要

多囊卵巢综合征(PCOS)与不良妊娠结局相关,包括流产、早产甚至新生儿结局的风险增加。在去除 COH 对患者的影响后,研究 FET 后不同 PCOS 表型患者的妊娠结局可能更能反映不同 PCOS 表型对 ART 结局的影响。回顾性收集并评估了 2017 年 1 月至 2019 年 10 月期间接受 FET 的 8903 名患者的数据。所有患者均根据 Rotterdam 标准分为对照组和四组表型组。主要结局是 FET 后的妊娠结局。我们发现,与对照组相比,PCOS 表型 A 和 D 的患者流产(P = 0.010)和持续妊娠(P = 0.023)率显著升高。在调整了潜在混杂因素后,PCOS 表型 A 和 D 与流产风险增加相关(调整后的 OR,1.476,P = 0.016;调整后的 OR,1.348,P = 0.008)。这项研究的结果表明,在进行 FET 时,临床医生应个体化管理 PCOS 表型 A 和 D 的患者,以降低流产率并提高活产率,从而获得更好的妊娠结局。

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