Early miscarriage rate in lean polycystic ovary syndrome women after euploid embryo transfer – a matched-pair study

Abstract

The early miscarriage rate is reported to be higher in patients with polycystic ovary syndrome (PCOS) compared with non-PCOS patients. However, whether PCOS is an independent risk factor for early miscarriage is still controversial; to what extent embryonic aneuploidy accounts for miscarriages of PCOS is still unknown. In this 1:3 matched-pair study, 67 lean PCOS patients and 201 controls matched for age, body mass index (BMI) and embryo scores undergoing a single euploid blastocyst transfer in vitrified-warmed cycles were analysed. Clinical pregnancy, early miscarriage and live birth rates were compared. Logistic regression analysis was performed to further evaluate the factors associated with early miscarriage and live birth. Clinical pregnancy rates were 50.7% in PCOS and 55.2% in control groups. Early miscarriage rate was significantly (P = 0.029) increased in the PCOS group compared with controls; non-PCOS patients had a significantly higher live birth rate than PCOS patients, P < 0.001. Further regression analyses showed that PCOS was significantly associated with a higher risk of early miscarriage and decreased chance of live birth. In conclusion, PCOS in women undergoing pre-implantation genetic diagnosis may, independently from BMI and karyotype, increase the risk of miscarriage.

The Prevalence of Incidental Endometriosis in Women Undergoing Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome: A Retrospective Cohort Study and Meta-Analysis

“…This suggests that complete resection of endometriosis might have a substantial role even in pain-asymptomatic women. In addition, another factor is the influence of endometriosis on early miscarriage, which is known to be greater in women with PCOS [38]. Miscarriage rates were reportedly higher in endometriosis patients than in disease-free women [39].…”

Hyperandrogenism and insulin resistance‐induced fetal loss: evidence for placental mitochondrial abnormalities and elevated reactive oxygen species production in pregnant rats that mimic the clinical features of polycystic ovary syndrome

“…; Luo et al . ). Abnormalities in oocytes, embryos and the placenta, as well as disruptions in the processes of uterine decidualization and embryo implantation, have all been implicated in pregnancy‐related complications and obstetric outcomes in PCOS patients (Jauniaux & Burton, ; Rai & Regan, ), but we lack a complete understanding regarding the contribution of maternal, placental and fetal factors to the onset of miscarriage in these patients.…”

Prenatal androgen induced lean PCOS impairs mitochondria and mRNA profiles in oocytes

“…PCOS is associated with increased obstetric risks including preeclampsia, gestational diabetes, preterm delivery and higher infant mortality (2). PCOS patients have higher miscarriage rates (3,4), higher risk of ovarian hyperstimulation (OHSS) and increased risks in offspring born after assisted reproduction technology (ART) (5). Further, there are longstanding implications in chronic disease states such as hypertension, diabetes, depression, stroke and some cancers (2).…”