PCOS in women with normal body mass index is not associated with adverse obstetric and perinatal outcomes after IVF-FET.

RESEARCH QUESTION: Is polycystic ovary syndrome (PCOS) in women with normal body mass index (BMI) associated with adverse obstetric and perinatal outcomes following frozen embryo transfer (FET)?

DESIGN

This retrospective study included women with PCOS and normal BMI who underwent FET between 2010 and 2023. The control group comprised women with male factor infertility and normal BMI. The main outcomes were obstetric and perinatal complications. A generalized estimating equation logistic regression accounted for data clustering and adjusted for confounders. Propensity score matching (PSM) was used to confirm the findings.

RESULTS

This study included 707 women with PCOS and 5692 controls. For singleton pregnancies, multivariable analyses showed no significant increase in risk for gestational diabetes mellitus [adjusted OR (aOR) 1.13, 95% CI 0.65-1.97], hypertensive disorders of pregnancy (aOR 1.62, 95% CI 0.61-4.32), abnormal placentation (aOR 0.89, 95% CI 0.33-2.42), preterm premature rupture of membranes (aOR 1.38, 95% CI 0.49-3.94) or caesarean section (aOR 1.12, 95% CI 0.78-1.61) for women with PCOS. All birth outcomes were similar between the groups [preterm birth (aOR 1. 86, 95% CI 0.81-4.28), low birthweight (aOR 1.33, 95% CI 0.52-3.43), small for gestational age (aOR 0.59, 95% CI 0.24-1.44), and large for gestational age (LGA) (aOR 1.01, 95% CI 0.68-1.51)]. For twin pregnancies, the above-listed outcomes were also comparable, except the odds of LGA infants were significantly lower in women with PCOS (aOR 0.42, 95% CI 0.21-0.86). PSM confirmed these findings.

CONCLUSIONS

Among women with normal BMI, PCOS is not associated with increased obstetric and perinatal complications compared with controls following FET.