BackgroundOverweight/obese women with polycystic ovary syndrome (PCOS) are at increased risk of subfertility and complications of pregnancy, compared with normal-weight women. To implement controlled ovarian hyperstimulation (COH), the improved efficacy of the gonadotrophin-releasing hormone antagonist (GnRH-ant) protocol has been demonstrated, as well as frozen embryo transfer (FET).ObjectiveThis retrospective study evaluated the pregnancy outcomes after combined GnRH-ant protocol and FET in overweight/obese women with PCOS, with reference to that of normal-weight women with PCOS.MethodsWomen with PCOS (n = 398) who underwent the GnRH-ant protocol for COH followed by FET, were stratified as normal-weight (BMI < 24 kg/m2) or overweight/obese (BMI ≥24 kg/m2). The outcomes of pregnancy were compared.ResultsThe overweight/obese patients had significantly lower rates of embryo implantation (47.7%), live birth (47.8%), and live births of twins (10.9%) compared with the normal-weight group (58.4%, 60.8%, and 30.0%, respectively; P = 0.006, 0.015, and 0.000), while the rate of late abortion was significantly higher (11.0% cf. 3.8%, P = 0.030). BMI was the only significant factor affecting the probability of live birth.ConclusionThe pregnancy outcomes of overweight/obese women with PCOS after COH via the GnRH-ant protocol and FET remained at a significant deficit compared with that of normal-weight women with PCOS.
There are limited data concerning the placenta transfer characteristics and accumulation of polybrominated diphenyl ethers (PBDEs) in infants. However, PBDEs received increasing health concerns due to their endocrine disrupt and neurodevelopment toxicity effects. The present study assessed the accumulation of PBDEs in 30 paired placenta, breast milk, fetal cord blood, and neonatal urine samples collected from five major cities of the South China. The age of mothers ranged from 21 to 39 (mean 27.6±4.56). The ∑PBDE concentrations were 15.8±9.88 ng g(-1) lipid in placenta, 13.2±7.64 ng g(-1) lipid in breast milk, 16.5±19.5 ng g(-1) lipid in fetal cord blood, and 1.80±1.99 ng ml(-1) in neonatal urine. BDE-47 was the predominant congener in all types of human sample. Octa-BDEs such as BDE-196/-197 were detected highly in placenta and cord blood while moderately in breast milk and neonatal urine. Significant (p<0.01) correlations were observed for both total and most individual PBDEs in cord blood-maternal placenta and breast milk-urine paired individual samples. The extent of placental transfer of higher brominated BDEs such as BDE-196/-197 was greater than that of BDE-47. The estimated daily intake (EDI) analysis for breast-fed infants revealed that newborns in these areas were exposed to relatively high levels of PBDEs via breast milk. Our study not only provided systematic fundamental data for PBDE distribution but also revealed the placenta transfer characteristics of PBDE congeners in South China.
Extended culture (advanced embryo stage) in fresh and frozen cycles appeared to be associated with increased rates of MZT. The effect of the number of embryos transferred, ICSI and AH, and freeze-thaw procedures on the risk for MZT was not demonstrated.
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