Analysis of pregnancy outcomes after transplantation of frozen-thawed embryo transfer in PCOS patients
10.19405/j.cnki.issn1000-1492.2024.04.020
- Author:
Huifen Xiang
1
,
2
,
3
,
4
,
5
;
Pin Zhang
1
,
3
,
4
,
5
;
Zuying Xu
1
,
3
,
4
,
5
;
Zhenran Liu
1
,
3
,
4
,
5
;
Yue Huang
1
,
3
,
4
,
5
;
Yuting Huang
6
;
Qiong Wu
6
;
Yiran Li
6
;
Rong Li
2
;
Yunxia Cao
1
,
3
,
4
,
5
Author Information
1. Dept of Obstetrics and Gynecology , The First Afiliated Hospital of Anhui Medical University , Hefei 230022
2. Reproductive Medicine Center , Dept of Obstetrics and Gynecology , Peking University Third Hospital , Beijing 100191
3. NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract (Anhui Medical University) , Hefei 230032
4. Key Laboratory of Population Health Across Life Cycle (Anhui Medical University) , Ministry of Education of the Peoples Republic of China , Hefei 230032
5. Anhui Province Key Laboratory of Reproductive Health and Genetics , Hefei 230032
6. The First Clinical College of Anhui Medical University , Hefei 230032
- Publication Type:Journal Article
- Keywords:
polycystic ovary syndrome;
frozen-thawed embryo transfer;
pregnancy outcome;
blastocyst culture;
previous pregnancy history;
insulin resistance
- From:
Acta Universitatis Medicinalis Anhui
2024;59(4):684-689
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To investigate the factors influencing the pregnancy outcomes during frozen-thawed embryo transfer (FET) cycles in patients with polycystic ovary syndrome (PCOS) .
Methods :A retrospective analysis was conducted on patients ’data from 882 FET cycles . According to the pregnancy outcome , the patients were divided into non-implantation group (Group A) , abortion group ( Group B1) and live birth group ( Group B2) . Clinical data and laboratory parameters were compared among the three groups , and ordered Logistic regression analysis was used to study the factors influencing pregnancy outcomes after FET. Patients were also divided into four groups (C1-C4) based on the number of high-quality embryos obtained (0 - 3 , 4 - 6 , 7 - 10 , ≥11) , and their clinical data and laboratory parameters were compared .
Results :The clinical pregnancy rate , live birth rate , and miscarriage rate in the 882 treatment cycles were 71 . 09% (627/882) , 61 . 68% (544/882) , and 13 . 24% (83/627) ,respectively. Single-factor analysis showed significant differences in body mass index (BMI) , infertility type , human chorionic gonadotropin (hCG) day estradiol ( E2 ) level , number of retrieved oocytes , and number of high-quality embryos among Groups A , B1 , and B2 (P < 0. 05) . Further multiple Logistic regression analysis revealed that BMI(OR = 1 . 046 , 95% CI:1 . 001 - 1 . 093 , P = 0. 044) and a history of previous pregnancy(OR = 1 . 417 , 95% CI:1 . 030 - 1 . 950 , P = 0. 032) were independent risk factors for successful FET in PCOS patients , while an increased number of high-quality embryos was an independent protective factor for successful pregnancy. Based on the results of Group B2 , compared to Group A , OR = 0. 920 , 95% CI:0. 880 - 0. 962 , P = 0. 000;compared to Group B1 , OR = 0. 923 , 95% CI:0. 862 - 0. 988 , P = 0. 022 . Compared with the other three groups( C1-C3) , the total amount of gonadotropin (Gn) in the C4 group was the lowest and the number of oocytes obtained was the highest (P < 0. 05) . Multiple comparisons showed that Group C4 had lower BMI , follicle-stimulating hormone (FSH) , very low-density lipoprotein ( vLDL) levels , a higher luteinizing hormone and follicle-stimulating hormone ( LH/FSH) ratio compared to Group C1 (P < 0. 05) . Group C4 had lower fasting insulin (FINS) and homeostasis model assessment of insulin resistance ( HOMA-IR) levels compared to Group C3 , and higher high-density lipoprotein-cholesterol (HDL-C) and apolipoprotein A1 (Apo A1) levels compared to Groups C2 and C3 (P < 0. 05) .
Conclusion:BMI , the history of previous pregnancy and the number of high-quality embryos were both independent factors for predicting pregnancy outcomes in PCOS patients undergoing FET cycles . Patients with a higher number of high-quality embryos have a higher clinical pregnancy rate during FET cycles .
- Full text:2024070321090096174多囊卵巢综合征患者冻融胚胎...周期妊娠结局的影响因素分析_向卉芬.pdf
