130: Adverse pregnancy outcomes after in vitro fertilization: effect of number of embryos transferred and plurality at conception

Abstract Background Menstrual patterns of patients with polycystic ovary syndrome (PCOS) is considered to be related to metabolism, but no study has analyzed the outcome of in vitro fertilization in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of in vitro fertilization in patients with PCOS with different menstrual patterns and infertility who used the long-acting long-term follicular phase Methods This was a retrospective analysis of the first cycle of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. The clinical data of 1620 patients with PCOS with oligomenorrhea or amenorrhea in the long-acting regimen. According to menstrual patterns, they were divided into the oligomenorrhea group and the amenorrhea group. Clinical characteristics, pregnancy outcome and fetal birth weight were compared between both groups. According to the pregnancy outcome of clinical pregnancy, participants were divided into the normal pregnancy group and the unfavorable pregnancy group. Logistic regression was used to analyze the relationship between menstrual patterns and the relevance of adverse pregnancy outcomes. Results Clinical pregnancy rates of patients with PCOS treated using long-acting long-term follicular phase were similar between the two groups (76.86% vs. 76.86%, p = 0.999). However, the incidence of adverse pregnancy outcomes in the amenorrhea group was higher than that in the oligomenorrhea group (p = 0.009). The incidences of macrosomia and very low birth weight in infants were also higher. Adjustment for confounding factors showed that menstrual patterns could influence the occurrence of adverse pregnancy outcomes (odds ratio = 0.643; 95% confidence interval, 0.406–0.961; p = 0.045). The body mass index, endometrial thickness on the day of hCG administration, and the number of eggs harvested were also independent predictors of poor pregnancy outcomes. Conclusion(s): Among PCOS patients with different menstrual patterns, IVF/ICSI assisted pregnancy can achieve similar pregnancy rates. However, patients with PCOS who have amenorrhea have a higher incidence of adverse pregnancy outcomes than those with oligomenorrhea. Perinatal surveillance should be strengthened during pregnancy to reduce the incidence of maternal and neonatal adverse outcomes.

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Differences in First-Trimester Maternal Metabolomic Profiles in Pregnancies Conceived From Fertility Treatments

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2018-01118 ◽

2018 ◽

Vol 104 (4) ◽

pp. 1005-1019 ◽

Cited By ~ 4

Author(s):

Tianyanxin Sun ◽

Bora Lee ◽

Jason Kinchen ◽

Erica T Wang ◽

Tania L Gonzalez ◽

...

Keyword(s):

In Vitro Fertilization ◽

Pregnancy Outcomes ◽

First Trimester ◽

Maternal Plasma ◽

Adverse Outcomes ◽

Hormone Production ◽

Vitro Fertilization ◽

Fertility Treatments ◽

Adverse Pregnancy

Abstract Context Maternal metabolic status reflects underlying physiological changes in the maternal-placental-fetal unit that may help identify contributors to adverse pregnancy outcomes associated with infertility and treatments used. Objective To determine if maternal metabolomic profiles differ between spontaneous pregnancies and pregnancies conceived with fertility treatments that may explain the differences in pregnancy outcomes. Design Metabolon metabolomic analysis and ELISAs for 17-β-estradiol and progesterone were performed during the late first trimester of pregnancy. Setting Academic institution. Subjects Women in the Spontaneous/Medically Assisted/Assisted Reproductive Technology cohort (N = 409), 208 of whom conceived spontaneously and 201 with infertility [non in vitro fertilization treatments (NIFT), n=90; in vitro fertilization (IVF), n=111]. Intervention Mode of conception. Main Outcome Measures Levels of of 806 metabolites within eight superpathways, 17-β-estradiol, and progesterone in maternal plasma in the late first trimester. Results Metabolomic differences in the lipid superpathway (i.e., steroid metabolites, lipids with docosahexaenoyl acyl chains, acyl cholines), and xanthine and benzoate metabolites (P < 0.05) were significant among the spontaneous and two infertility groups, with greatest differences between the spontaneous and IVF groups. 17-β-estradiol and progesterone levels were significantly elevated in the infertility groups, with greatest differences between the spontaneous and IVF groups. Conclusion Metabolomic profiles differ between spontaneous and infertility pregnancies, likely driven by IVF. Higher levels of steroids and their metabolites are likely due to increased hormone production from placenta reprogrammed from fertility treatments, which may contribute to adverse outcomes associated with infertility and the treatments used.

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