Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

Han, Ae Ra; Kim, Hye Ok; Wha, Sun; Park, Chan Woo; Kim, Jin Yeong; Yang, Kwang Moon; Song, In Ok; Koong, Mi Kyoung; Kang, Inn Soo

doi:10.5653/cerm.2011.38.2.103

Cited by 50 publications

(88 citation statements)

References 20 publications

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“…Being overweight in prepregnancy is an important predictor for the risk of perinatal complications in women with PCOS [19,20]. Another report showed that the prevalence of GDM and fetal macrosomia was significantly higher in overweight versus normal-weight women with PCOS [21]. Regarding obesity, we observed a high prevalence of GDM with glucose intolerance and high insulin secretion at preconception in overweight and obese patients with PCOS, but there was no macrosomia (data not shown).…”

Section: Discussionsupporting

confidence: 48%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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POLYCYSTIC OVARY SYNDROME (PCOS) is a common endocrine and metabolic disorder present in 5-15% of women of reproductive age depending on the diagnostic criteria used [1,2]. The common features of PCOS are hyperandrogenism, irregular menstruation and polycystic ovaries by ultrasonography [3,4]. In addition, insulin resistance, hyperandrogenism and obesity might play important roles in the pathophysiologic process of PCOS, and the interaction of these factors might result in an increased risk of not only type 2 diabetes mellitus, metabolic syndrome and cardiovascular disease [5][6][7] Abstract. Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by insulin resistance and hyperandrogenism. The interaction of these factors might result in increased risks of miscarriage and pregnancy complications such as gestational diabetes mellitus (GDM). To examine the pregnancy risks in women with PCOS, we compared obstetrical outcomes between patients with and without PCOS. We also studied the differences in maternal characteristics, glucose intolerance and pregnancy complications between PCOS patients with and without GDM, with and without obesity, and between successful pregnancies and miscarriages. We observed a high incidence of GDM and prevalence of GDM diagnosis in the first trimester in PCOS. Patients with GDM had higher body mass index (BMI) and lower homeostasis model assessment of β-cell function (HOMA-β) at preconception than those without GDM. Obese pregnant women with PCOS demonstrated a high incidence of GDM with severe insulin resistance, including high fasting insulin, HOMA of insulin resistance (HOMA-IR), and HOMA-β at preconception compared with normal-weight patients. BMI was significantly correlated with HOMA-IR or HOMA-β, and both indices were lower in PCOS patients with than without GDM for the same BMI. There were no significant differences in maternal characteristics (excluding maternal age) between PCOS patients with successful pregnancy and PCOS patients with miscarriages. Our data suggest that pregnant women with PCOS have an increased risk of GDM, especially if they have obesity and/or poorer insulin secretion. Measure of β-cell function, such as HOMA-β, at preconception might be a useful predictor of the risk of GDM in pregnant PCOS patients.Key words: Polycystic ovary syndrome, Insulin resistance, Pregnancy complication, Gestational diabetes mellitus gestational diabetes mellitus (GDM) [8].Because insulin resistance and obesity might affect the course of pregnancy in women with PCOS, we compared the obstetrical outcomes between the patients with PCOS and without PCOS. We also examined the differences in maternal characteristics and perinatal outcomes between PCOS patients with and without GDM and with and without obesity. Furthermore, we examined the differences in maternal characteristics between successful pregnancies and miscarriages to determine the risks of pregnancy loss in women with PCOS. Materials and MethodsA total of 64 Japanese pregnant women with PCOS (includ...

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Section: Discussionsupporting

confidence: 48%

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

et al. 2015

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“…The miscarriage rate (the proportion of miscarriages in all clinical pregnancies) in the slow-freezing group was higher (29 vs 15.7 %), especially in the case of single embryo transfers. The miscarriage rate were higher than presented in previous studies in the case of day 3 FET cycles by Liu et al (12.6 vs 12.1 %) or Rama Raju et al (7.71 vs 9.24 %) [21,24], but it did not differ from the results of a study on the miscarriage rate after fresh embryo transfers (17.4-22.2 %) in PCO and tubal infertility [25]. The most common reason for early pregnancy miscarriages is the chromosomal abnormalities irrespective the mode of fertilization (spontaneous or ART) [26][27][28].…”

Section: Discussioncontrasting

confidence: 71%

The freezing method of cleavage stage embryos has no impact on the weight of the newborns

Kaartinen

Kananen²,

Huhtala

et al. 2016

J Assist Reprod Genet

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Purpose The aim of this study was to study the effect of the embryo freezing method on the birth weight of newborns from frozen embryo transfer (FET) cycles, and the pregnancy results of cleavage stage embryos cryopreserved by slow freezing or vitrification. Methods This is a retrospective cohort study undertaken in a University Hospital IVF unit using concurrently both the slow-freezing and the vitrification techniques. All frozenthawed and vitrified-warmed day 2 and day 3 embryo transfers during the time period from 1 April 2009 to 31 November 2013 were included in the study. Results There was no statistically significant weight difference between newborns from vitrified or slow-frozen embryos (3588 vs 3670 g). A higher post-thaw viability rate was achieved after cryopreservation by the vitrification technique compared to the slow-freezing protocol (83.4 vs 61.4 %). The miscarriage rate was lower in the vitrification group (15.7 vs 29.0 %). The live birth rates were similar (19.5 vs 19.1 %) in the slow-freezing and vitrification groups, respectively. Among vitrified embryos, 7.4 embryos needed to be thawed to produce one delivery; in the slow-freezing group, that number was 11.9. Conclusions The freezing method has no impact on the weight of the newborn.With lower post-thaw survival rates and higher miscarriage rates, the slow-freezing cryopreservation protocol is inferior to the vitrification technique.

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“…Publication bias was detected significant by using the Egger test (P= 0.03). It was notable that sensitivity analysis ‘see Additional file 3: Figure S2’ with the exclusion of one study with borderline eligibility [44], did substantial decrease in insignificant heterogeneity (χ 2 : P=0.309, I 2 = 13.5%), and the difference in risk of development PIH between women with PCOS and controls remained robust [13 studies, fixed effects OR 3.43 (95% CI: 2.49–4.74), Figure 2]. Meta-regression failed to provide evidence of a significant effect between outcome and study type (retrospective vs. prospective) (P=0.17) or BMI (P= 0.54).…”

Section: Resultsmentioning

confidence: 99%

Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis

Qin

Pang

et al. 2013

Reprod Biol Endocrinol

260

206

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BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age. The risk of pregnancy and neonatal complications in women with PCOS is debatable. In order to determine the risk of pregnancy and neonatal complications, evidence regarding these risks was examined.MethodsLiterature searches were performed in the electronic databases MEDLINE, EMBASE, and CENTRAL based on the established strategy and eligible tries were included according to inclusion and exclusion criteria. A systematic literature review looking at rates of gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preeclampsia, premature delivery, neonatal birth weight, caesarean section and admission to a neonatal intensive care unit (NICU) was conducted in women with PCOS. Pregnancy outcomes between women with PCOS versus controls were included. Sensitivity analyses were performed to determine the reliability of the available evidence and to validate the results. The study was performed with the approval of the ethics committee of the First Affiliated Hospital of Guangxi Medical University.ResultsA total of 27studies, involving 4982 women with PCOS and 119692 controls were eligible for the meta-analysis. Women with PCOS demonstrated a significantly higher risk of developing GDM (OR3.43; 95% CI: 2.49–4.74), PIH (OR3.43; 95% CI: 2.49–4.74), preeclampsia (OR2.17; 95% CI: 1.91–2.46), preterm birth (OR1.93; 95%CI: 1.45–2.57), caesarean section (OR 1.74; 95% CI: 1.38–2.11) compared to controls. Their babies had a marginally significant lower birth weight (WMD −0.11g; 95%CI: -0.19 – -0.03), and higher risk of admission to NICU (OR 2.32; 95% CI: 1.40–3.85) compared to controls.ConclusionsWomen with PCOS have increased risk of adverse pregnancy and neonatal complications. It is necessary to establish guidelines for supervision during pregnancy and parturition to prevent these complications.

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Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study

Cited by 50 publications

References 20 publications

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome

The freezing method of cleavage stage embryos has no impact on the weight of the newborns

Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis

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