scholarly journals Comparison of Stimulated Cycles with Low Dose r-FSH versus Hormone Replacement Cycles for Endometrial Preparation Prior to Frozen-Thawed Embryo Transfer in Young Women with Polycystic Ovarian Syndrome: A Single-Center Retrospective Cohort Study from China

2021 ◽  
Vol Volume 15 ◽  
pp. 2805-2813
Author(s):  
Li Li ◽  
Dan-Dan Gao ◽  
Yi Zhang ◽  
Jing-Yan Song ◽  
Zhen-Gao Sun
2021 ◽  
Author(s):  
Li Li ◽  
Dan-Dan Gao ◽  
Yi Zhang ◽  
Jing-Yan Song ◽  
Zhen-Gao Sun

Abstract Objective The principal purpose of this study was to compare reproductive outcomes for stimulated cycles (STC) and hormone replacement cycles (HRC) for endometrial preparation before frozen-thawed embryo transfer (FET) in young women with polycystic ovary syndrome (PCOS). Methods We conducted a retrospective study of 1434 FET cycles from January, 2017 to March, 2020 in our reproductive center, in which stimulated and hormone replacement cycles were used for endometrial preparation. Pregnancy outcomes of couples undergoing routine STC-FET or HRC-FET were analyzed before and after propensity score matching (PSM). Results Data on 1234 HRC protocols (86% of the total) and 200 STC protocols (14%) were collected. After PSM, 199 patients were included in both groups, respectively. There was no significant difference in positive pregnancy rate (52.7% vs. 54.8%, p = 0.763), clinical pregnancy rate (51.8% vs. 52.8%, p = 0.841), live birth rate (45.2% vs. 43.7%, p = 0.762), pregnancy loss rate (9.7% vs. 16.2%, p = 0.164) and ectopic pregnancy rate (1.5% vs. 0.5%, p = 0.615) between STC protocols and HRC protocols. Conclusion STC for endometrial preparation had similar pregnancy outcomes compared with HRC protocols by excluding heterogeneous factors after PSM. Evidence is available which shows that for young women with PCOS who were undergoing in-vitro fertilization, HRC could be a reasonable choice for patients who are unwilling to accept injections. Additionally, STC may offer more flexibility for young PCOS patients and reproductive centres.


2021 ◽  
Author(s):  
Xitong Liu ◽  
Juanzi Shi ◽  
Haiyan Bai

Abstract Background: The optimal means to prepare the endometrial preparation for PCOS patients is a topic of ongoing controversy. Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in polycystic ovary syndrome (PCOS) patients. Methods: In this retrospective cohort study, we evaluated 1638 consecutive cycles between June 2014 and December 2017 in the Assisted Reproduction Center of Northwest Women’s and Children’s Hospital. The patients who underwent FET were assigned to two groups as follows: hormone replacement treatment (HRT) group, comprising 1115 cycles; HRT with GnRHa pretreatment (GnRHa + HRT), comprising 523 cycles. Patients using GnRHa + HRT (n=519) were matched with 519 patients using HRT. Results: The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.4% vs 55.5%, p=0.062). The clinical pregnancy rate (72.74% vs 75.33%), miscarriage rate (14.26% vs 13.96%) and ectopic pregnancy rate (0.36% vs 0.38%) were similar between the two groups. The preterm birth rate in HRT was lower than GnRHa + HRT (14.08% vs 20.08%). There were no significant interactions in any of the subgroups (p>0.05 for all comparisons). In the unadjusted model and adjusted model, the live birth rate was comparable between GnRHa + HRT and HRT group (OR 1.22, 95%CI, 0.99-1.51, p=0.062; aOR 1.56, 95%CI, 1.001-2.41, p=0.048). Similar results were obtained after propensity score matching in the entire cohort. Conclusions: GnRHa pretreatment could not improve the live birth rate in women with PCOS.


Author(s):  
Jaya Patel ◽  
Shailesh Rai

Background: Polycystic ovarian syndrome (PCOS) associated with multiple presentation in females although it is common disorder but due to lack of knowledge females often delays in getting confirm diagnosis and treatment. PCOS remains a syndrome and as such no single diagnostic criterion is sufficient for clinical diagnosis. Objective: To assess the knowledge about PCOS in young women.Methods: Cross sectional study was performed on 400 women of age group 18-30 years either studying in Colleges or working in Indore city. Written informed consent was obtained and simple random technique was applied for selection of study participants. Pre-designed, pre-tested, semi-structured questionnaire was used for data collection. The data collected were analyzed through percentages and frequencies using Excel. Relevant statistical test was applied was applied and p value was calculated where ever required and considered statistically significant when it is <0.05.Results: Among 400 participants, only 41% of the women were aware of the term PCOS. 46% of the subjects who were aware about the organ system involved in this disease. Most of the people know about this disorder through friends or relatives. 49% of the women knew about the various signs and symptoms associated with PCOS.Conclusions: The results of present study show that very few of the young women understand what this disease is and what are the earliest symptoms that should alarm them to consult a physician.  Discussion with the girls in college authors came to know that most of the people are considering menstrual pain and irregularities as a part of their physiological process and do not consider consulting a doctor.


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