The influence of polycystic ovarian syndrome on obstetric and neonatal outcomes after frozen-thawed embryo transfer.

RESEARCH QUESTION: Does polycystic ovary syndrome (PCOS) affect pregnancy and neonatal outcomes after frozen-thawed embryo transfers (FET) using hormone replacement therapy (HRT) cycles or stimulated cycles?

DESIGN

This was a retrospective cohort study in which singletons born to 1876 women with PCOS and 14,630 women without PCOS under the age of 38 years from 2010 to 2018 were analyzed at a tertiary care academic medical center. The main outcomes were gestational diabetes mellitus (GDM), pregnancy-induced hypertension, preterm premature rupture of membranes (PPROM) and early preterm birth (EPTB).

RESULTS

Women with PCOS showed a higher risk of GDM (adjusted odds ratio [aOR] 1.71, 95% confidence interval [CI] 1.47-1.99), pregnancy-induced hypertension (aOR 1.46, 95% CI 1.13-1.90), PPROM (aOR 1.40, 95% CI 1.02-1.79) and EPTB (aOR 1.51, 95% CI 1.01-2.26) compared with mothers without PCOS. Considering that more PCOS received HRT cycles, subgroup analyses were performed separately for stimulated cycles and HRT cycles. PCOS was not correlated with PPROM and EPTB in the two subgroups. The rate of GDM, pregnancy-induced hypertension and EPTB among women with without PCOS using stimulated cycles appeared to be lower than in women without PCOS using HRT cycles.

CONCLUSIONS

Although PCOS indeed confers independent risks for GDM and pregnancy-induced hypertension after FET compared with no PCOS, risks of other adverse outcomes (e.g. PPROM and EPTB) might be exaggerated owing to a higher proportion of HRT cycles used in PCOS.