Pregnancy Outcomes of Women With Polycystic Ovary Syndrome for the First In Vitro Fertilization Treatment: A Retrospective Cohort Study With 7678 Patients.
Pregnancy Outcomes of Women With Polycystic Ovary Syndrome for the First In Vitro Fertilization Treatment: A Retrospective Cohort Study With 7678 Patients.
复制标题
首次体外受精治疗的多囊卵巢综合症女性的妊娠结局：一项包含 7678 名患者的回顾性队列研究
DOI：
10.3389/fendo.2020.575337
复制
发表时间：
2020
影响因子：
5.2
通讯作者：
Diao L
中科院分区：
文献类型：
--
作者：
Liu S;Mo M;Xiao S;Li L;Hu X;Hong L;Wang L;Lian R;Huang C;Zeng Y;Diao L
背景：多囊卵巢综合征（PCOS）的诊断会增加不良妊娠结局的风险。然而，先前研究中的混杂因素排除了确定的结论，需要进一步的研究。目的探讨多囊卵巢综合征（PCOS）是否影响首次体外受精（IVF）治疗的不孕妇女的妊娠结局和并发症，并考虑重要的混杂因素。方法我们对7，678名不孕妇女进行了一项回顾性队列研究，其中包括2010年1月至2017年12月期间在私人生育中心接受首次IVF治疗的666名多囊卵巢综合征妇女和7，012名对照妇女。我们的主要结果是PCOS对不良妊娠结局（流产、早产、妊娠高血压）和妊娠结局（活产率、临床妊娠率、种植率）的影响。在控制母体特征后，通过校正比值比（aOR）和95%置信区间（CI）总结PCOS效应。结果在校正了母亲年龄、BMI、不孕持续时间、促性腺激素总剂量、hCG触发日血清E2和子宫内膜厚度、受精卵细胞数、移植胚胎数、胚胎类型等因素后，（卵裂期胚胎或囊胚）和质量，PCOS妇女发生不良妊娠并发症的风险增加，包括流产（aOR 1.629，95%CI 1.240-2.141），极早产（< 32周）（aOR 2.072，95%CI 1.133-3.791）。在妊娠结局方面，在调整上述混杂因素后，PCOS与较高的临床妊娠率（aOR 1.248，95% CI 1.038-1.501）和种植率（aOR 1.238，95% CI 1.030-1.489）相关。结论在调整了母亲特征的差异后，PCOS妇女不良妊娠结局的风险增加。这些妇女在怀孕和分娩期间可能需要更频繁的医疗咨询和管理。
Background The risk of adverse pregnancy outcomes is increased by having a polycystic ovary syndrome (PCOS) diagnosis. However, the confounders in previous studies preclude firm conclusions, and further studies are warranted. Objectives To investigate whether PCOS affects pregnancy outcomes and complications in infertile women undergoing their first in vitro fertilization (IVF) treatment, taking into account important confounders. Methods We performed a retrospective cohort study of 7,678 infertile women, including 666 women with PCOS and 7,012 controls undergoing their first IVF treatment at a private fertility center from January 2010 to December 2017. Our main outcome was the impact of PCOS on adverse pregnancy outcomes (miscarriage, preterm delivery, pregnancy-induced hypertension) and pregnancy outcomes (live birth rate, clinical pregnancy rate, implantation rate). PCOS effects were summarized by adjusted odds ratios (aORs) with 95% confidence intervals (CIs) after controlling for maternal characteristics. Results After adjusting for differences in maternal age, BMI, infertility duration, total dose of gonadotropin, serum E2 and endometrial thickness on the day of hCG trigger, number of fertilized occytes, number of embryos transferred, embryo type (cleavage-stage embryo or blastocyst) and quality, women with PCOS had an increased risk of developing unfavorable pregnancy complications, including miscarriage (aOR 1.629, 95% CI 1.240–2.141), very preterm delivery (< 32 weeks) (aOR 2.072, 95% CI 1.133–3.791). For pregnancy outcomes, PCOS was associated with higher clinical pregnancy rate (aOR 1.248, 95% CI 1.038–1.501) and implantation rate (aOR 1.238, 95% CI 1.030–1.489) after adjusting for the above-mentioned confounders. Conclusions Women with PCOS are at increased risk of adverse pregnancy outcomes after adjusting for differences in maternal characteristics. These women may need more frequent medical consultants and management during pregnancy and parturition.