Overview of Long-Term Morbidity and Economic Cost of the Polycystic Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women, affecting approximately 5-20% of women of reproductive age. A previous estimate noted that the economic burden of PCOS approximates $3.7 billion annually in 2020 USD when considering only the costs of the initial diagnosis and of reproductive endocrine morbidities, not considering the costs of pregnancy-related and long-term morbidities. Objective To estimate the excess prevalence and economic burden of pregnancy-related and long-term health morbidities attributable to PCOS. Data Sources PubMed, EmBase and Cochrane Library. Study Selection Studies in which the diagnosis of PCOS was consistent with the Rotterdam, National Institutes of Health (NIH), or Androgen Excess & PCOS (AE-PCOS) Society criteria, or that used electronic medical record diagnosis codes, or diagnosis based on histopathologic sampling were eligible for inclusion. Studies that included an outcome of interest and a control group of non-PCOS patients who were matched or controlled for body mass index (BMI) were included. Data Extraction Two investigators working independently extracted data on study characteristics and outcomes. Data Synthesis Data was pooled using random-effects meta-analysis. The I 2statistic was used to assess inter-study heterogeneity. The quality of selected studies was assessed using the Newcastle-Ottawa Scale. Results The additional total healthcare-related economic burden due to pregnancy-related and long-term morbidities associated with PCOS in the United States is estimated to be $4.3 billion annually in 2020 USD. Conclusions Together with our prior analysis, the economic burden of PCOS is estimated at $8 billion annually in 2020 USD.

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Management of polycystic ovary syndrome involves addressing current needs and preventing long-term consequences

Drugs & Therapy Perspectives ◽

10.2165/00042310-200723050-00004 ◽

2007 ◽

Vol 23 (5) ◽

pp. 12-14

Author(s):

&NA;

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Long Term Consequences

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Long-term consequences of polycystic ovary syndrome: Results of a 31 year follow-up study

Human Fertility ◽

10.1080/1464727002000198781 ◽

2000 ◽

Vol 3 (2) ◽

pp. 101-105 ◽

Cited By ~ 170

Author(s):

Sarah Wild ◽

Tracey Pierpoint ◽

Howard Jacobs ◽

Paul McKeigue

Keyword(s):

Polycystic Ovary Syndrome ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Follow Up Study ◽

Long Term Consequences

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GnRH Antagonist Versus Modified Prolonged GnRH Agonist Protocol in Polycystic Ovary Syndrome (PCOS): Analysis Using Propensity Score Matching

10.21203/rs.3.rs-63654/v1 ◽

2020 ◽

Author(s):

Leizhen Xia ◽

Lifeng Tian ◽

Jun Tan ◽

Shanshan Zhang ◽

Qiong-Fang Wu

Keyword(s):

Polycystic Ovary Syndrome ◽

Live Birth ◽

Birth Rate ◽

Gnrh Antagonist ◽

Polycystic Ovary ◽

Economic Cost ◽

Live Birth Rate ◽

Ovary Syndrome ◽

The Cost ◽

Severe Ohss

Abstract Background: Women with polycystic ovary syndrome (PCOS) have been reported with low pregnancy rate and high OHSS risk in in vitro fertilization (IVF) programs due to the decreased endometrial receptivity and high ovarian reserve. The aim of the study was to compare the effectiveness, safety and economic cost of GnRH antagonist (GnRH-ant) and modified prolonged GnRH agonist (mGnRH-a) protocol in PCOS patients.Methods: This study was a retrospective cohort study that included 2164 women with (PCOS) undergoing assisted reproductive technology (ART) treatment from January 2014 to April 2019. Among them, 2018 women received mGnRH-a treatment and 146 women received GnRH antagonist (GnRH-ant) treatment. The two groups were matched by propensity scores with a ratio of 1:4 (GnRH-ant versus mGnRH-a) accounting for potential confounding factors. The primary outcomes were the live birth rate (LBR), incidence of moderate-to-severe OHSS and the cost of controlled ovarian hyperstimulation (COH). LBR was defined as live birth per started treatment cycle after first fresh or frozen embryo transfer.Results: Women with the mGnRH-a protocol had an increased endometrial thickness on HCG injection day, compared with GnRH-ant protocol (10.84 vs. 9.62, P<0.001), furthermore, the number of transferable embryos on day 3 (7 vs. 5, P=0.022), clinical pregnancy rate (67.81% vs. 52.74%, P=0.0007), implantation rate (56.05%, vs. 43.44%, P<0.001) and live birth rate (58.22% vs. 41.78%, P=0.0004) were also significantly higher in the mGnRH-a protocol group. However, there were no significant differences in the incidence of moderate-to-severe OHSS (4.28% vs. 2.05%, P=0.333), the incidence of severe OHSS (0.17% vs. 0%, P=1) and the cost of COH (RMB: 7736.9 vs. 8046.54, P=0.113). Conclusion: The mGnRH-a protocol has a higher live birth rate than GnRH-ant protocol with the similar safety and economic cost among infertile women with PCOS.

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