loading page

Early and late pregnancy loss in women with polycystic ovary syndrome undergoing IVF/ICSI treatment: a retrospective cohort analysis of 21,820 pregnancies.
  • +3
  • He Cai,
  • Stephan Gordts,
  • Hui Wang,
  • Tao Wang,
  • Na Li,
  • juanzi Shi
He Cai
Northwest Women and Children's Hospital
Author Profile
Stephan Gordts
Life Expert Centre
Author Profile
Hui Wang
Northwest Women and Children's Hospital
Author Profile
Tao Wang
Northwest Women and Children's Hospital
Author Profile
Na Li
Northwest Women and Children's Hospital
Author Profile
juanzi Shi
Northwest Women and Children's Hospital
Author Profile

Abstract

Objective To examine early and late pregnancy loss in women with and without polycystic ovary syndrome (PCOS) undergoing IVF/ICSI transfers. Design Retrospective cohort study. Setting Reproductive medicine center at a tertiary hospital. Population Records were reviewed for women with a positive β-hCG after IVF/ICSI treatment from May 2014 to April 2019. Methods Odds ratios (ORs) for early (13 ≤weeks) and late (13-24 weeks) pregnancy loss were calculated among women with and without PCOS for plurality of the pregnancy with adjustment for confounding factors. Main outcomes measures Early and late pregnancy loss. Results A total of 21,820 charts identified with a positive β-hCG, 2,357 (10.8%) subjects had PCOS, and 19,463 (89.2%) controls did not. Early pregnancy loss occurred in 12.4% of women with PCOS versus 12.8% in women with non-PCOS. Women with PCOS demonstrated a higher rate of late pregnancy loss (5.4% in PCOS vs 3.1% in non-PCOS, OR 1.79, 95%CI, 1.46-2.19, P<.001), regardless of the plurality of the pregnancy (one gestational sac: 4.1 vs. 2.7 percent, OR 1.56, 95%CI,1.18-2.05; ≥ two gestational sacs: 8.1 vs. 4.1 percent, OR 2.08, 95%CI,1.54-2.82, PCOS vs. Non-PCOS, respectively). Potential negative impact of PCOS was reduced to marginal level once BMI were taken into account (aOR 1.42, 95% CI, .99-2.03). BMI and maternal comorbidities were independently associated with late pregnancy loss (aOR 1.65, 95%CI, 1.26-2.17 and aOR 2.07,95%CI,1.43-3.00). Conclusions PCOS women with overweight and preexisting comorbidities would benefit from lifestyle intervention and close surveillance throughout the whole pregnancy.

Peer review status:IN REVISION

05 Aug 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
06 Aug 2020Assigned to Editor
06 Aug 2020Submission Checks Completed
09 Aug 2020Reviewer(s) Assigned
21 Aug 2020Review(s) Completed, Editorial Evaluation Pending
07 Sep 2020Editorial Decision: Revise Major