多囊卵巢综合征对体外受精/胞浆内单精子注射新鲜周期妊娠后流产率的影响。
The influence of polycystic ovary syndrome on abortion rate after in vitro fertilization/intracytoplasmic sperm injection fresh cycle pregnancy.
机构信息
Department of Reproductive Medicine, The Second Affiliated Hospital of Zhengzhou University, No. 2, Jingba Road, Zhengzhou, 450014, China.
出版信息
Sci Rep. 2023 Apr 12;13(1):5978. doi: 10.1038/s41598-023-32988-5.
There are many reports on clinical pregnancy outcomes in polycystic ovary syndrome (PCOS) patients receiving vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI), but little research about abortion has been done and there is a debate on whether the abortion risk increases in PCOS patients receiving IVF/ICSI. Therefore, the aim of this study was to investigated the abortion in PCOS patients. Clinical data of 12055 IVF/ICSI fresh cycles performed in our hospital from January 2015 to December 2020 were collected. Based on the Rotterdam diagnostic criteria of PCOS and after propensity score matching (PSM) for baseline data of clinical pregnancy cycles, matched 599 PCOS (PCOS group) and Non-PCOS (non-PCOS group) cycles were obtained. Abortion and abortion-related outcomes were compared between the two groups. Risk factors for late abortion in twins were analyzed using binary Logistics regression. Post-PSM data showed that the late abortion rate was significantly higher in the PCOS group than in the non-PCOS group only in twin pregnancy (9.50% vs. 3.96%, OR: 2.55, 95%CI 1.10-5.89). There were no statistical differences in other pregnancy outcomes. The etiological distribution for late abortion were not statistically different between the two groups in both singletons and twins. Logistics regression indicated that PCOS and obesity [pregnancy-assisted body mass index (BMI) ≥ 28] were risk factors for late abortion in twin pregnancy. In twin pregnancy, PCOS and obese patients are more likely to have late abortion. In twin pregnancy, the late abortion risk significantly increased in the PCOS patients as compared with non-PCOS patients (OR: 2.59, 95%CI 1.11-6.03, P < 0.05), as well as in the patients with obesity (BMI ≥ 28) as compared with the patients with normal BMI (OR: 4.17, 95%CI 1.59-10.90, P < 0.05). PCOS does not significantly affect early and overall late abortion rates after IVF/ICSI fresh cycle pregnancy.
多囊卵巢综合征（PCOS）患者接受体外受精（IVF）或卵胞浆内单精子注射（ICSI）后，有许多关于临床妊娠结局的报道，但关于流产的研究较少，并且关于 PCOS 患者接受 IVF/ICSI 是否会增加流产风险存在争议。因此，本研究旨在探讨 PCOS 患者的流产情况。收集了 2015 年 1 月至 2020 年 12 月我院 12055 例 IVF/ICSI 新鲜周期的临床数据。根据 PCOS 的鹿特丹诊断标准，并对临床妊娠周期的基线数据进行倾向性评分匹配（PSM）后，获得了匹配的 599 例 PCOS（PCOS 组）和非 PCOS（非 PCOS 组）周期。比较两组之间的流产和流产相关结局。采用二元逻辑回归分析双胞胎晚期流产的危险因素。PSM 后数据显示，仅在双胞胎妊娠中，PCOS 组的晚期流产率明显高于非 PCOS 组（9.50%比 3.96%，OR：2.55，95%CI 1.10-5.89）。其他妊娠结局无统计学差异。两组在单胎和双胞胎中晚期流产的病因分布无统计学差异。逻辑回归表明，PCOS 和肥胖[妊娠辅助体重指数（BMI）≥28]是双胞胎妊娠晚期流产的危险因素。在双胞胎妊娠中，PCOS 和肥胖患者更容易发生晚期流产。在双胞胎妊娠中，与非 PCOS 患者相比，PCOS 患者的晚期流产风险显著增加（OR：2.59，95%CI 1.11-6.03，P<0.05），与 BMI 正常的患者相比，肥胖患者（BMI≥28）的晚期流产风险显著增加（OR：4.17，95%CI 1.59-10.90，P<0.05）。PCOS 并不显著影响 IVF/ICSI 新鲜周期妊娠后早期和整体晚期流产率。
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