Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

ObjectiveTo investigate the results of in vitro fertilization among polycystic ovary syndrome (PCOS) patients using the long-acting long protocol regarding the relationship between menstrual patterns and adverse pregnancy outcomes.DesignRetrospective cohort study.SettingUniversity-affiliated reproductive medical center.BackgroundThe menstrual patterns of patients with PCOS is considered related to metabolism; however, no study has analyzed the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of IVF/ICSI in patients with PCOS with different menstrual patterns who used the long-acting long protocol.MethodsThis was a retrospective analysis in the first cycle of IVF/ICSI at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. In total, 1834 patients with PCOS were classified into the regular menstruation group (n=214), the oligomenorrhea group (n=1402), and the amenorrhea group (n=218).ResultsPCOS patients who used the long-acting long protocol of IVF/ICSI had similar clinical pregnancy rates and live birth rates despite having different menstrual patterns. The overall incidence of adverse pregnancy outcomes, including abortion, spontaneous preterm birth (sPTB), gestational diabetes(GDM), hypertensive disorder inpregnancy (HDP), and premature rupture of membranes(PROM, was significantly higher in the amenorrhea group than in the regular menstrual and oligomenorrhea groups (25.88% vs. 30.41% vs. 43.69%; P = 0.013). Additionally, the rates of GDM (2.35% vs. 6.10% vs. 13.79%; P=0.015) and macrosomia (5.26% vs. 10.94% vs. 18.39%; P=0.026) in the amenorrhea group were significantly higher than those in the other two groups. Correction for confounding factors showed that menstrual patterns are related to the occurrence of adverse pregnancy outcomes. Amenorrhea is an independent risk factor for adverse pregnancy outcome (OR [odds ratio]: 2.039, 95% CI [confidence interval]: 1.087-3.822), GDM (OR: 5.023, 95% CI: 1.083–23.289), and macrosomia (OR: 4.918, 95% CI: 1.516–15.954).ConclusionsIVF/ICSI can achieve similar pregnancy and live birth rates in PCOS patients with different menstrual patterns. However, the overall incidence of adverse pregnancy outcomes in PCOS patients with amenorrhea is higher than that in patients with regular menstruation or oligomenorrhea.

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Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome Undergoing in Vitro Fertilization/Intracytoplasmic Sperm Injection Embryo Transfer Cycles with The Long-Acting Long-Term Follicular Phase: A Retrospective Analysis

10.21203/rs.3.rs-680392/v1 ◽

2021 ◽

Author(s):

Ting Yu ◽

Di Wu ◽

Yurong Cao ◽

Jun Zhai

Keyword(s):

In Vitro Fertilization ◽

Pregnancy Outcomes ◽

Follicular Phase ◽

Adverse Pregnancy Outcomes ◽

Vitro Fertilization ◽

Menstrual Patterns ◽

Adverse Pregnancy ◽

Long Acting

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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