Effect of body mass index on pregnancy outcomes with the freeze-all strategy in women with polycystic ovarian syndrome

Abstract

Objective: To investigate the effects of body mass index (BMI) on assisted reproductive outcomes with the freeze-all strategy for patients with polycystic ovary syndrome (PCOS). Design: Retrospective cohort study. Setting: Tertiary care academic medical center. Patient(s): A total of 3,079 women with PCOS across different BMIs at our institution from January 2015 to May 2017 were stratified into cohorts. Intervention(s): None. Main Outcome Measure(s): Implantation rate, clinical pregnancy rate, early miscarriage rate, and live birth rate. Result(s): The live birth rate was most favorable in underweight (BMI < 18.5 kg/m 2 ) and normal weight cohorts (18.5 % BMI < 25 kg/ m 2 ) and progressively decreased as BMI increased. Moreover, the obese cohort (BMI R 30 kg/m 2 ) of patients with PCOS who had frozen ET cycles had a relatively high early miscarriage rate. Conclusion(s):The live birth rates are highest in underweight and normal weight patients with PCOS undergoing IVF with the freeze-all strategy. Furthermore, there is a progressive and statistically significant decrease in the live birth rate and an increase in the miscarriage rate in obese patients with PCOS. (Fertil Steril Ò 2019;112:1172-9. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

High BMI and Insulin Resistance Are Risk Factors for Spontaneous Abortion in Patients With Polycystic Ovary Syndrome Undergoing Assisted Reproductive Treatment: A Systematic Review and Meta-Analysis

“…Outcomes of interest were reported in 11182 patients in 17 retrospective cohort studies ( 20 – 26 , 28 , 30 – 36 , 40 , 41 ), three prospective cohort studies ( 38 , 39 , 42 ) and two case-control studies ( 27 , 37 ). Fourteen studies were conducted in China ( 22 , 23 , 25 , 28 , 30 – 33 , 35 , 36 , 38 , 39 , 41 , 42 ), five in the USA ( 20 , 21 , 24 , 26 , 27 ), and the remaining three in Japan ( 37 ), Turkey ( 34 ), and Australia ( 40 ).…”

“…Outcomes of interest were reported in 11182 patients in 17 retrospective cohort studies ( 20 – 26 , 28 , 30 – 36 , 40 , 41 ), three prospective cohort studies ( 38 , 39 , 42 ) and two case-control studies ( 27 , 37 ). Fourteen studies were conducted in China ( 22 , 23 , 25 , 28 , 30 – 33 , 35 , 36 , 38 , 39 , 41 , 42 ), five in the USA ( 20 , 21 , 24 , 26 , 27 ), and the remaining three in Japan ( 37 ), Turkey ( 34 ), and Australia ( 40 ). Seventeen studies measured BMI ( 20 – 26 , 30 – 32 , 34 – 38 , 41 , 42 ), four assessed age ( 28 , 30 , 37 , 40 ), three evaluated insulin resistance ( 30 , 37 , 42 ), five investigated chromosome aberrations ( 26 , 30 , 31 , 33 , 39 ), and the other four assessed hyperandrogenism ( 27 , 30 , 37 , 42 ).…”

“…Fifteen articles with a total of 7499 patients evaluated the relationship between spontaneous abortion and BMI in PCOS patients undergoing ART ( 20 – 26 , 32 , 34 – 38 , 41 , 42 ), including 13 articles with categorical variables ( 20 – 26 , 32 , 34 – 36 , 38 , 41 ) and two with continuous variables ( 37 , 42 ). Assessment of the risk of bias demonstrated a symmetrical funnel chart, indicating no publication bias ( Supplementary Figure 2 ).…”

“…Nevertheless, it is still unclear whether the above mentioned risk factors were comprehensive and whether they could cause an increase in the spontaneous abortion rate in PCOS patients undergoing ART. For instance, controversies exist regarding the role of obesity or overweight in adverse pregnancy outcomes in PCOS patients, with some authors ( 20 , 36 ) considering obesity as a risk factor for adverse pregnancy outcomes while others ( 35 ) finding that BMI had no adverse effects on the pregnancy outcome. In view of these controversies, we believed that a meta-analysis was necessary to evaluate the risk factors of spontaneous abortion in PCOS patients undergoing ART in order to provide recommendations for clinical treatment of PCOS.…”

Catechins from oolong tea improve uterine defects by inhibiting STAT3 signaling in polycystic ovary syndrome mice

“…An increasing number of clinical studies indicate that impaired endometrial function leads to recurrent miscarriages, preterm births, endometrial hyperplasia, and canceration in patients with PCOS [23]. Other studies have shown an association between many endometrial cell lines and inflammation-related molecular disorders under PCOS conditions [24].…”