Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2023 Aug 24;14:1204623. doi: 10.3389/fendo.2023.1204623. eCollection 2023.
Overweight and obese are important factors leading to the occurrence of long-term complications in women with polycystic ovary syndrome (PCOS). There has been controversy over whether dissatisfaction with pregnancy outcomes in PCOS patients is influenced by chronic inflammatory status or obesity. This retrospective study analyzed the levels of inflammatory factors in PCOS patients with different body mass index (BMI) groups and effective predictors of fertilization/intracytoplasmic sperm injection (IVF/ICSI) pregnancy outcomes.
There were 273 women with PCOS diagnosed who completed serum inflammatory factors test between January 2017 and June 2022 were selected. The data of 7,649 infertility PCOS patients who received their first IVF/ICSI treatment in the Reproductive Center of Peking University Third Hospital during the period of the study were collected. Finally, 92 PCOS patients were included in the high BMI group, while 97 patients were included in the normal BMI group. Baseline characteristics were collected and the pregnancy outcomes were compared among the two groups. Then, serum inflammatory factors' effect on IVF/ICSI pregnancy outcomes were analyzed with age, anti-Mullerian Hormone (AMH) and BMI adjusted.
PCOS patients in the high BMI group significantly had a lower number of oocytes retrieved and good quality embryos. The high BMI group PCOS patients had higher levels of IL-6 and lower cumulative clinical pregnancy and live birth rates. The level of GM-CSF was higher in the first cycle transfer and cumulative miscarriage group. High TNF-α was negatively correlated with the first transfer cycle and cumulative clinical pregnancy rates after age, AMH and high BMI adjusted. In addition, the cumulative live birth rate was negatively correlated with high IL-6, but the first cycle transfer and cumulative live birth rates were positively correlated with high IL-1β.
For PCOS patients, in addition to BMI, attention should also be paid to inflammatory indicators. High levels of TNF-α and IL-6 were negatively correlated with pregnancy outcomes, but high IL-1β was positively correlated with live birth rates among PCOS patients. The level of GM-CSF was higher in miscarriage PCOS patients.
超重和肥胖是导致多囊卵巢综合征（PCOS）女性发生长期并发症的重要因素。关于 PCOS 患者对妊娠结局的不满是否受慢性炎症状态或肥胖的影响，一直存在争议。本回顾性研究分析了不同体质量指数（BMI）组 PCOS 患者的炎症因子水平及对体外受精/卵胞浆内单精子注射（IVF/ICSI）妊娠结局的有效预测因素。
选取 2017 年 1 月至 2022 年 6 月期间在北京大学第三医院生殖医学中心完成血清炎症因子检测的 273 例 PCOS 患者，收集同期该中心行首次 IVF/ICSI 治疗的 7649 例不孕 PCOS 患者的临床资料，最终纳入高 BMI 组 92 例，正常 BMI 组 97 例。比较两组患者的基本情况，并对两组患者的妊娠结局进行比较。然后，在调整年龄、抗苗勒管激素（AMH）和 BMI 后，分析血清炎症因子对 IVF/ICSI 妊娠结局的影响。
高 BMI 组 PCOS 患者获卵数及优质胚胎数显著减少，累积临床妊娠率及活产率较低。高 BMI 组 PCOS 患者血清 IL-6 水平较高，GM-CSF 水平在第 1 次移植周期及累积流产组中较高，TNF-α 水平与年龄、AMH 和高 BMI 调整后的第 1 次移植周期及累积临床妊娠率呈负相关。此外，累积活产率与高 IL-6 呈负相关，而第 1 次移植周期和累积活产率与高 IL-1β呈正相关。
对于 PCOS 患者，除 BMI 外，还应关注炎症指标。高 TNF-α 和 IL-6 水平与妊娠结局呈负相关，而高 IL-1β 水平与 PCOS 患者的活产率呈正相关。流产 PCOS 患者的 GM-CSF 水平较高。
