Association of Polycystic Ovary Syndrome Phenotypes With Adverse Pregnancy Outcomes After In-Vitro Fertilization/Intracytoplasmic Sperm Injection

Abstract

ObjectiveThis study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes and adverse perinatal outcomes, comparing the characteristics, ovarian response, and assisted reproductive outcomes in patients with various PCOS phenotypes after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).MethodsThis study comprised 6,732 patients who underwent the first cycle of IVF/ICSI treatment in our outpatient department from January 2017 to July 2018. Propensity score matching (PSM) was used in PCOS and non-PCOS groups to balance the influence of intergroup confounding factors. After the PSM procedure, 1,186 patients were included in the two groups, and the PCOS patients were further divided into four PCOS phenotype groups based on the Rotterdam criteria.ResultsPatients with various PCOS phenotypes had similar rates of biochemical pregnancy, clinical pregnancy, and live birth (all P-values > 0.05). The overall incidence of adverse pregnancy outcomes (including ectopic pregnancy, miscarriage, preterm birth) was significantly higher in PCOS phenotype A and D groups than in the control group (44% and 46.4% vs. 28.7%, P = 0.027). The rates of hypertensive disorder of pregnancy (HDP) were significantly higher in PCOS phenotype A and C groups than in the control group (9.3% and 12.5% vs. 3.1%, P = 0.037). After adjustment for potential confounders, the differences in adverse pregnancy outcomes persisted (P = 0.025).ConclusionsThe overall incidence of adverse pregnancy outcomes is higher in women with PCOS phenotypes A and D than in women with non-PCOS.

Association between the Different Phenotypes of Polycystic Ovary Syndrome and the Outcome in <i>in Vitro</i> Fertilization at Human Reproductive Center Paul et Chantal Biya-Yaoundé

“…Age was comparable in the different phenotypes. These results were close to whom the total doses were comparable in the different phenotypes [3].…”

“…We thus distinguish four phenotypes. PCOS is the major cause of anovulatory infertility [3] [4] [5] [6]; In Vitro Fertilization (IVF) constitutes the final stage of care for this group of patients and according to several authors, the outcome in IVF/ICSI (In Vitro Fertilization/Intracytoplasmic Sperm Injection) would depend on the PCOS phenotype [3] [6] [7] [8]. Thus, given the recurrence of cases of PCOS admitted for ovarian stimulation for IVF/ICSI at the Hospital Center for Research and Application in Endoscopic Surgery and Human Reproduction (CHRACERH) and the fact that no study on this subject has been carried out in our context which we proposed to carry out this study.…”

Ovulation Induction Outcome with Different Phenotypes Of PCOS

“…A similar study by Wang et al indicated that the PCOS phenotype was correlated with adverse pregnancy outcomes (ectopic pregnancy, miscarriage, and premature birth), and PCOS phenotypes A and D were the independent risk factors for adverse pregnancy outcomes. However, CPR and LBR in various PCOS phenotypes were comparable in that study [18], even with a significantly larger population group. Few studies have tried correlating the PCOS Phenotype with oocyte morphology and ICSI outcome [19,20], although the connection has been conflicting [21].…”

Metabolic Syndrome Rather Than Other Phenotypes in PCOS as a Predictive Indicator for Clinical Outcomes in IVF: Comprehensive Phenotypic Assessment across All PCOS Classifications

“…De Vos et al demonstrated that phenotype D had a higher live birth rate and cumulative clinical pregnancy rate compared to phenotypes A and C, after excluding the influence of phenotype B [49]. When compared to those without PCOS, the incidence of adverse pregnancy outcomes, such as ectopic pregnancy, miscarriage, preterm birth, and hypertensive disorders, was found to be higher in women with PCOS exhibiting phenotypes A and D [50]. HA phenotype PCOS is associated with increased rates of spontaneous abortion and pregnancy loss.…”