Zhao Xueqing, Ye Shenglong, Yan Xin, Li Rong, Wang Yongqing
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). 2025 Jun 26;16:1498443. doi: 10.3389/fendo.2025.1498443. eCollection 2025.
This study aims to investigate the risk factors associated with cervical insufficiency (CI) in women with polycystic ovarian syndrome (PCOS) who have undergone fertilization and embryo transfer (IVF-ET) treatment.
This study included 746 women diagnosed with PCOS. These women successfully achieved pregnancy through IVF-ET between 2016 and 2023 and subsequently delivered at Peking University Third Hospital. Women were categorized into a study group and a control group based on the presence of CI. Additionally, stratified analyses were performed within each group according to whether fresh or frozen embryos were used for transfer, to investigate the clinical characteristics and risk factors associated with CI.
In women with PCOS undergoing IVF-ET, BMI (OR=1.195, 95% CI: 1.043-1.290, P<0.001), AMH (OR=1.158, 95% CI: 1.092-1.227, P<0.001), frequency of hysteroscopy operations (OR=1.587, 95% CI: 1.202-2.094, P=0.001), prior gravidity (OR=1.956, 95% CI: 1.459-2.621, P<0.001), and occurrence of twin pregnancies (OR=3.028, 95% CI: 1.563-5.865, P=0.001) were found to be positively associated with the incidence of CI. The cut-off value of BMI and AMH were respectively 22.25kg/m and 9.965ng/ml. Different IVF-ET protocols and hysteroscopic operation within 6 months before pregnancy is not a risk factor for CI. Among women with PCOS undergoing fresh embryo transfer, elevated androstenedione levels (OR=3.250, 95% CI: 1.129-9.359, P=0.029) were identified as a risk factor for CI. In contrast, for women with PCOS undergoing frozen embryo transfer, multiple factors including BMI (OR=1.254, 95% CI: 1.134-1.388, P<0.001), AMH levels (OR=1.232, 95% CI: 1.144-1.327, P<0.001), frequency of hysteroscopy procedures (OR=1.603, 95% CI: 1.155-2.224, P=0.005) and prior gravidity (OR=2.423, 95% CI: 1.674-3.508, P<0.001), were associated with an increased risk of CI.
The study analysed risk factors for cervical insufficiency in women with PCOS who underwent IVF-ET treatment, such as BMI, AMH, frequency of hysteroscopy operations, prior gravidity, twin pregnancy. Providing a basis for the identification and prediction of people at high risk of cervical insufficiency.
本研究旨在调查接受体外受精-胚胎移植（IVF-ET）治疗的多囊卵巢综合征（PCOS）女性中与宫颈机能不全（CI）相关的危险因素。
本研究纳入746例诊断为PCOS的女性。这些女性于2016年至2023年间通过IVF-ET成功受孕，并随后在北京大学第三医院分娩。根据是否存在CI将女性分为研究组和对照组。此外，在每组中根据移植使用的是新鲜胚胎还是冷冻胚胎进行分层分析，以研究与CI相关的临床特征和危险因素。
在接受IVF-ET的PCOS女性中，发现体重指数（BMI）（OR=1.195，95%CI：1.043-1.290，P<0.001）、抗缪勒管激素（AMH）（OR=1.158，95%CI：1.092-1.227，P<0.001）、宫腔镜手术次数（OR=1.587，95%CI：1.202-2.094，P=0.001）、既往妊娠次数（OR=1.956，95%CI：1.459-2.621，P<0.001）以及双胎妊娠的发生（OR=3.028，95%CI：1.563-5.865，P=0.001）与CI的发生率呈正相关。BMI和AMH的截断值分别为22.25kg/m²和9.965ng/ml。不同的IVF-ET方案以及妊娠前6个月内的宫腔镜手术不是CI的危险因素。在接受新鲜胚胎移植的PCOS女性中，雄烯二酮水平升高（OR=3.250，95%CI：1.129-9.359，P=0.029）被确定为CI的危险因素。相比之下，对于接受冷冻胚胎移植的PCOS女性，包括BMI（OR=1.254，95%CI：1.134-1.388，P<0.001）、AMH水平（OR=1.232，95%CI：1.144-1.327，P<0.001）、宫腔镜检查次数（OR=1.603，95%CI：1.155-2.224，P=0.005）和既往妊娠次数（OR=2.423，95%CI：1.674-3.508，P<...
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