Comparing the risk of adverse pregnancy outcomes of Chinese patients with polycystic ovary syndrome with and without antiandrogenic pretreatment

Li, Yanglu; Ruan, Xiangyan; Wang, Husheng; Lü, Xue; Cai, Guiju; Du, Juan; Wang, Limin; Zhao, Yue; Mueck, Alfred O.

doi:10.1016/j.fertnstert.2017.12.023

Cited by 38 publications

(23 citation statements)

References 35 publications

(43 reference statements)

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“…A systematic review demonstrated that features characteristic of PCOS before pregnancy, such as hyperandrogenism, obesity, insulin resistance and metabolic abnormalities, might contribute to the increased risk of HDP 29 . If ethinylestradiol/cyproterone acetate was used as pretreatment for hyperandrogenism among women with PCOS, the risk of GDM, pregnancy‐induced hypertension, and preterm birth was decreased 13 . Although the value of the Rotterdam criteria to guide treatment is controversial, research evidence has shown that the Rotterdam criteria have advantages in predicting reproductive outcomes 30 .…”

Section: Discussionmentioning

confidence: 99%

“…Clinical and biochemical hyperandrogenism were both included in the diagnosis of hyperandrogenism. Clinical hyperandrogenism was indicated by symptoms including hirsutism, acne and androgenic alopecia 13 . Biochemical hyperandrogenism was diagnosed if testosterone exceeded 76 ng/dl according to the reference value of our laboratory.…”

Section: Methodsmentioning

confidence: 99%

“…Clinical hyperandrogenism was indicated by symptoms including hirsutism, acne and androgenic alopecia. 13 Biochemical hyperandrogenism was diagnosed if testosterone exceeded 76 ng/dl according to the reference value of our laboratory. All patients underwent non-donor IVF/ICSI at the Reproductive Medicine Centre of Tongji Hospital without using preimplantation genetic diagnosis or preimplantation genetic screening.…”

Section: Study Population and Designmentioning

confidence: 99%

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The effect of polycystic ovary syndrome without hyperandrogenism on pregnancy‐related outcomes: a retrospective cohort study

Long

et al. 2021

BJOG

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Objective To evaluate the effect of polycystic ovary syndrome (PCOS) without hyperandrogenism on pregnancy‐related outcomes. Design A retrospective cohort study. Setting Reproductive Medicine Centre of Tongji Hospital. Population Women without hyperandrogenism undergoing their first single blastocyst transfers in frozen–thawed cycles were divided into a PCOS group and a non‐PCOS group according to the Rotterdam criteria. Methods The pregnancy‐related outcomes of women with and without PCOS were compared. Propensity score matching and multiple logistic regression models were used to eliminate essential impacts on pregnancy‐related outcomes. Main outcome measures Pregnancy‐related outcomes included pregnancy loss and abnormal perinatal outcomes. Results A total of 4083 women without hyperandrogenism met the study criteria, among whom 557 met the diagnostic criteria for PCOS. Women with PCOS had higher rates of clinical pregnancy (P = 0.035) and cumulative live births (P = 0.023). However, there were no significant differences in the rates of biochemical pregnancy, twins and pregnancy loss between the two groups. Among women with singleton pregnancies, the incidences of preterm birth, hypertensive disorders of pregnancy, gestational diabetes, placenta praevia, fetal malformation, macrosomia and low birthweight did not differ significantly between the two groups. The results remained unchanged even after adjustments were made for propensity score matching and multiple logistic regression analyses. Conclusion Women with PCOS without hyperandrogenism may achieve higher rates of clinical pregnancy and cumulative live birth than those without PCOS, without increases in their rates of biochemical pregnancy, pregnancy loss or other abnormal perinatal outcomes. Tweetable abstract PCOS without hyperandrogenism was not associated with abnormal pregnancy‐related outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Population and Designmentioning

confidence: 99%

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The effect of polycystic ovary syndrome without hyperandrogenism on pregnancy‐related outcomes: a retrospective cohort study

Long

et al. 2021

BJOG

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“…Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, with an estimated prevalence of 10% around the world [1] and 5.6% in Chinese women aged 19-45 years [2]. This complex endocrine disturbance reflects multiple variable biochemical and clinical manifestations such as hyperandrogenism (HA), insulin resistance, dyslipidemia, obesity, and frequently with menstrual irregularities, infertility, and increased risk of adverse pregnancy outcomes [3][4][5]. These signs and complications can also lead to psychosocial and emotional disturbances and seriously affect quality of life [6,7].…”

Section: Introductionmentioning

confidence: 99%

Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

Tian

Ruan

et al. 2021

Reprod. Sci.

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To investigate sexual function in Chinese women with polycystic ovary syndrome (PCOS) and to explore the correlation with clinical and biochemical characteristics. A cross-sectional study was designed in 1000 PCOS women, aged 18–45 years, via the Chinese version of Female Sexual Function Index (FSFI) evaluating sexual function, with additional questions possibly related to sexual life. Clinical and biochemical characteristics likely to affect sexual function were determined, including anthropometric indicators, serum levels of hormones, luteinizing hormone to follicle-stimulating hormone ratio (LH/FSH ratio), prolactin (PRL), total testosterone (TT), free androgen index (FAI), sex-hormone-binding globulin (SHBG), glucose, and lipid metabolism indicators. Nine hundred ten PCOS women participated in the study, 685 patients were included after screening, and 211 were suitable to detect correlations of clinical and biochemical characteristics with sex function parameters. The mean total FSFI score was 24.19 ± 2.8; 79.56% of the women were at risk of female sexual dysfunction (FSD). Women doing regular aerobic exercise and use of contraception had higher FSFI scores, while those with a desire to conceive and clinical signs of hyperandrogenism had lower FSFI scores. There were negative associations of FSFI scores with age and body fat distribution. No significant associations between FSFI scores and hormonal factors (surprisingly including SHBG) were found, except for total testosterone and satisfaction (OR = 0.976, p = 0.002). HOMA-IR was significantly related to reduced desire score (OR = 0.914, p = 0.004) and lubrication score (OR = 0.964, p = 0.044). PCOS was associated with a high risk of FSD (defined according to FSFI) in about 80% of the women in our study, and clinical characteristics play a more important role.

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“…Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease characterized by menstrual disorder, oligo/anovulation, hyperandrogenemia, polycystic ovaries, and insulin resistance. [ 1 ] Studies [ 2 , 3 ] show that PCOS with complex etiology affects 6% to 15% women of childbearing age, approximately 75% of whom experience infertility due to anovulation. The pathogenesis of PCOS is mostly metabolic disorder caused by insulin resistance and secondary hyperinsulinemia, which can lead to endometrial cancer, cardiovascular disease, type 2 diabetes, and other diseases over time, affecting women's physical, and mental health.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of different forms of Guizhi Fuling Wan on reproduction and metabolism in women with polycystic ovary syndrome

Liu

Zhu

et al. 2020

Medicine

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Background: Polycystic ovary syndrome (PCOS), is a common endocrine disorder in women characterized by increased androgen levels, ovulatory dysfunction, and polycystic ovaries. Western medicine is widely used for the treatment of PCOS, but patient satisfaction is low, largely due to its associated gastrointestinal symptoms of nausea and diarrhea. Guizhi Fuling Wan (GFW) is a traditional Chinese medicine used to remove blood stasis and dissipate phlegm for treating gynecological diseases that was invented by Zhang Zhongjing in the Eastern Han dynasty. In recent years, GFW has been widely used to treat patients with PCOS. This study aims to assess the efficacy and safety of GFW in the treatment of PCOS through a systematic review and meta-analysis. Methods: All randomized controlled trials connected with GFW targeting PCOS will be searched in the following electronic bibliographic databases from their earliest recorded publications to December 2020 without any language restrictions: MEDLINE, Embase, PubMed, Web of Science, China National Knowledge Infrastructure, Chinese Biological Medicine Database, Wan-fang data, Chinese Technical Periodicals, and other databases. The primary outcomes include Sex hormone levels, ovulation rate, pregnancy rate, and total effective rate. The secondary outcomes were Total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, fasting glucose, fasting insulin, insulin sensitivity index, body mass index, hypertrichosis score, acne score, adverse reactions, etc. Two reviewers will independently conduct cations retrieval, de-duplication, filtering, quality assessment, and data analysis by Endnote X9.1 and Review Manager software (RevMan V.5.3). Meta-analysis and/or subgroup analysis will be performed on the included data. Discussion: This study will investigate the application of GFW in the treatment or prevention of PCOS, and provide a high-quality synthesis to judge whether GFW is an effective and safe intervention for PCOS. PROSPERO registration number: CRD42020192405

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Comparing the risk of adverse pregnancy outcomes of Chinese patients with polycystic ovary syndrome with and without antiandrogenic pretreatment

Abstract: In our highly selected study population, patients with PCOS are more likely to develop GDM, PIH, and PD. Pretreatment with EE/CPA was associated with a lower risk of GDM, PIH, and PD.

Cited by 38 publications

References 35 publications

The effect of polycystic ovary syndrome without hyperandrogenism on pregnancy‐related outcomes: a retrospective cohort study

The effect of polycystic ovary syndrome without hyperandrogenism on pregnancy‐related outcomes: a retrospective cohort study

Sexual Function in Chinese Women with Polycystic Ovary Syndrome and Correlation with Clinical and Biochemical Characteristics

Efficacy of different forms of Guizhi Fuling Wan on reproduction and metabolism in women with polycystic ovary syndrome

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