Independent Variables for Determining the Cumulative Live Birth Rates of Aged Patients with Polycystic Ovary Syndrome or Tubal Factor Infertility: A Retrospective Cohort Study

ObjectiveTo assess whether women of advanced age (≥35 years) with polycystic ovary syndrome (PCOS) have the same cumulative live birth rate (CLBR) as their age-matched controls with tubal factor infertility and to determine the influencing factors on the CLBRs of aged women.DesignA retrospective cohort study.Setting and PopulationA total of 160 women of advanced age (≥35 years) with PCOS and 1073 women with tubal factor infertility were included in our study. All patients underwent their first fresh cycles and subsequent frozen cycles within in one year in our centre from 2015 to 2020.MethodsTo determine independent influencing factors on the CLBRs of these aged patients, a multivariable Cox regression model of CLBR according to the transfer cycle type was constructed. Main outcome measure(s): CLBRs.ResultThe Cox regression model of the CLBRs indicated that there was no significant difference between the PCOS group and the tubal infertility group in terms of advanced age (HR, 0.95; 95% CI, 0.71-1.27, P=0.732). The CLBR significantly decreased for women of advanced reproductive age up to 37 years of age (HR, 0.46; 95% CI, 0.39-0.56, P<0.001). The CLBR increased by 63% when more than ten oocytes were retrieved (HR, 1.63; 95% CI, 1.34-1.98, P<0.001). Patients with an AMH level above 32.13pmol/l were likely to have a 72%(HR, 1.72; 95% CI, 1.08-2.73, = 0.023) and 34% (HR, 1.34; 95% CI, 1.07-1.68, P=0.010)improvement in CLBR compared to those with an AMH below 7.85pmol/l and 7.85-32.12pmol/l, respectively.ConclusionDespite the higher number of oocytes retrieved in PCOS patients, the reproductive window is not extended for PCOS patients compared with tubal factor infertility patients. Age, AMH and the number of oocytes retrieved play crucial roles in the CLBRs of patients of advanced age (≥35 years).

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Independent Variables for Determining the Cumulative Live Birth Rates of Aged Patients With Polycystic Ovary Syndrome or Tubal Factor Infertility: A Retrospective Cohort Study

10.21203/rs.3.rs-143361/v1 ◽

2021 ◽

Author(s):

Pingping Kong ◽

Zhiying Xiao ◽

Junyan Zhang ◽

Jingfang He ◽

Wenjun Geng ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Cox Regression ◽

Polycystic Ovary ◽

Advanced Age ◽

Ovary Syndrome ◽

Tubal Infertility ◽

Aged Patients ◽

Tubal Factor Infertility ◽

Cumulative Live Birth ◽

Tubal Factor

Abstract Background: Women with polycystic ovary syndrome (PCOS) have a higher ovarian reserve and 9 number of oocytes retrieved than women with tubal infertility. To assess whether women of 10 advanced age (≥35 years) with PCOS have the same cumulative live birth rate (CLBR) as their age-11 matched controls with tubal factor infertility and to determine the influencing factors on the CLBRs 12 of aged women. 13 Methods: A total of 190 women of advanced age (≥35 years) with PCOS and 627 women with tubal 14 factor infertility were included in our study. All patients underwent their first fresh cycles and 15 subsequent frozen cycles in our centre from 2007 to 2018. To determine independent influencing 16 factors on the CLBRs of these aged patients, a multivariable Cox regression model of CLBR 17 according to the transfer cycle type was constructed. 18 Results: The Cox regression model of the CLBRs indicated that there was no significant difference 19 between the PCOS group and the tubal infertility group in terms of advanced age (HR, 0.96; 95% CI, 20 0.77~1.20). The CLBR significantly decreased for women of advanced reproductive age up to 37 21 years of age (HR, 0.65; 95% CI, 0.53~0.80). The CLBR increased by 31% when more than ten 22 oocytes were retrieved (HR, 1.31; 95% CI, 1.08~1.59). In addition to age and the number of oocytes, 23 the addition of recombinant LH was an independent factor that increased the CLBRs of the women of 24 advanced age (HR, 1.25; 95% CI, 1.03~1.53). 25 Conclusions: Despite the higher number of oocytes retrieved in PCOS patients, the reproductive 26 window is not extended for PCOS patients compared with tubal factor infertility patients. Age, the 27 number of oocytes retrieved and supplementation with LH play crucial roles in the CLBRs of 28 patients of advanced age (≥35 years).

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P–590 Women with hypothalamic hypogonadism have lower live birth rates following frozen embryo transfer

Human Reproduction ◽

10.1093/humrep/deab130.589 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

R Heidenberg ◽

A Lanes ◽

E Ginsburg ◽

C Gordon

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Polycystic Ovary ◽

Frozen Embryo Transfer ◽

Fresh Embryo Transfer ◽

Ovary Syndrome ◽

Birth Rates ◽

Live Birth Rates ◽

Tubal Factor Infertility ◽

Tubal Factor

Abstract Study question How do live birth rates differ in anovulatory women with polycystic ovary syndrome and hypothalamic hypogonadism compared to normo-ovulatory women undergoing fresh or frozen embryo transfer? Summary answer Live birth rates are similar among all groups undergoing fresh embryo transfer but are significantly lower in women with hypothalamic hypogonadism undergoing frozen embryo transfer. What is known already Conflicting data exist regarding pregnancy outcomes in patients with tubal factor infertility versus polycystic ovary syndrome (PCOS). Some studies demonstrate higher pregnancy and live birth rates for women with PCOS undergoing fresh embryo transfer, but other studies demonstrate no difference. Women with PCOS have higher live birth rates than those with tubal factor infertility when undergoing frozen embryo transfer. Fewer data are available regarding IVF outcomes in women with hypothalamic hypogonadism (HH) and tubal factor infertility. Several studies report comparable live birth rates with fresh embryo transfer, but there are no data on frozen embryo transfer outcomes. Study design, size, duration Retrospective cohort study of all fresh and frozen autologous embryo transfers performed for patients with oligo-anovulation (PCOS, n = 380 and HH, n = 39) and normo-ovulation (tubal factor infertility, n = 315) from 1/1/2012 to 6/30/2019. A total of 734 transfers from 653 patients were analyzed. Participants/materials, setting, methods Transfer outcomes, including implantation, miscarriage, clinical pregnancy and live birth rates, were assessed in fresh and frozen embryo transfer cycles. Adjusted relative risks (RR) and 95% confidence intervals (CI) were calculated adjusting for age, BMI, stimulation protocol, number of embryos transferred, embryo quality, endometrial stripe thickness and day of transfer. Poisson regression was used for counts and with an offset for ratios. Generalized estimating equations were used to account for patients contributing multiple cycles. Main results and the role of chance For fresh embryo transfer cycles, live birth rates are similar among patients with tubal factor infertility, PCOS and HH (29.5% vs. 37.9% vs. 35.9%, respectively, aRR 1.15 95% CI: 0.91–1.44 and aRR 1.23 95% CI: 0.81–2.00, respectively). When evaluating frozen embryo transfer cycles, patients with HH have lower live birth rates than patients with tubal factor infertility (26.5% vs. 42.6%, aRR 0.54 95% CI: 0.33–0.88) and patients with PCOS (26.5% vs. 46.7%, aRR 0.55 95% CI: 0.34–0.88). Additionally, patients with HH have higher chemical pregnancy rates and miscarriage rates than patients with tubal factor infertility (26.5% vs. 13.0% and 17.7% vs. 6.5%, respectively, RR 2.71 95% CI: 1.27–5.77 and RR 2.03 95% CI: 1.05–3.80, respectively). Point biserial correlation showed no significant correlation between live birth and endometrial stripe thickness in HH patients undergoing frozen embryo transfer (r = 0.028, p-value 0.876). Limitations, reasons for caution This study is limited by its retrospective nature and the small sample size of women with hypothalamic hypogonadism. Additionally, these data represent outcomes from a single academic center, so generalizability of our findings may be limited. Wider implications of the findings: Lower live birth rates for HH patients undergoing frozen embryo transfer cycles are not correlated with endometrial stripe thickness. This may be due to absent gonadotropin signaling on endometrial receptors. A prospective randomized trial of HH patients to modified natural versus programmed frozen embryo transfer would best support this hypothesis. Trial registration number Not applicable

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Diagnosis and management of polycystic ovary syndrome in the UK (2004–2014): a retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2016-012461 ◽

2016 ◽

Vol 6 (7) ◽

pp. e012461 ◽

Cited By ~ 14

Author(s):

Tao Ding ◽

Gianluca Baio ◽

Paul J Hardiman ◽

Irene Petersen ◽

Cormac Sammon

Keyword(s):

Cohort Study ◽

Polycystic Ovary Syndrome ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Diagnosis And Management ◽

The Uk

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Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study

Clinical Endocrinology ◽

10.1046/j.1365-2265.2000.01000.x ◽

2000 ◽

Vol 52 (5) ◽

pp. 595-600 ◽

Cited By ~ 396

Author(s):

Sarah Wild ◽

Tracey Pierpoint ◽

Paul McKeigue ◽

Howard Jacobs

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Polycystic Ovary Syndrome ◽

Retrospective Cohort ◽

Polycystic Ovary ◽

Ovary Syndrome ◽

Cardiovascular Disease In Women ◽

Long Term Follow Up

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Follicular Proinflammatory Cytokines and Chemokines as Markers of IVF Success

Clinical and Developmental Immunology ◽

10.1155/2012/606459 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 43

Author(s):

Aili Sarapik ◽

Agne Velthut ◽

Kadri Haller-Kikkatalo ◽

Gilbert C. Faure ◽

Marie-Christine Béné ◽

...

Keyword(s):

Polycystic Ovary ◽

Unexplained Infertility ◽

Ovary Syndrome ◽

Cytokines And Chemokines ◽

Tubal Factor Infertility ◽

Oocyte Fertilization ◽

Tubal Factor ◽

Mrna Analysis ◽

Bender Medsystems

Cytokines are key modulators of the immune system and also contribute to regulation of the ovarian cycle. In this study, Bender MedSystems FlowCytomix technology was used to analyze follicular cytokines (proinflammatory: IL-1β, IL-6, IL-18, IFN-γ, IFN-α, TNF-α, IL-12, and IL-23;, and anti-inflammatory: G-CSF), chemokines (MIP-1α, MIP-1β, MCP-1, RANTES, and IL-8), and other biomarkers (sAPO-1/Fas, CD44(v6)) in 153 women undergoingin vitrofertilization (IVF). Cytokine origin was studied by mRNA analysis of granulosa cells. Higher follicular MIP-1αand CD44(v6) were found to correlate with polycystic ovary syndrome, IL-23, INF-γ, and TNF-αwith endometriosis, higher CD44(v6) but lower IL-βand INF-αcorrelated with tubal factor infertility, and lower levels of IL-18 and CD44(v6) characterized unexplained infertility. IL-12 positively correlated with oocyte fertilization and embryo development, while increased IL-18, IL-8, and MIP-1βwere associated with successful IVF-induced pregnancy.

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