Association between hyperandrogenism and adverse pregnancy outcomes in patients with different polycystic ovary syndrome phenotypes undergoing <i>in vitro</i> fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis

Ma, Linna; Cao, Yurong; Ma, Yue; Zhai, Jing

doi:10.1080/09513590.2021.1897096

Cited by 23 publications

(15 citation statements)

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“…In 1988, Sagle et al [ 92 ] reported a high prevalence of PCOM in women who had recurrent miscarriages, which was later confirmed by other authors [ 93 ]. Additionally, available data emphasize the impact of HA on miscarriages [ 94 , 95 , 96 , 97 ], but the role of adrenal androgens has not been studied widely [ 98 , 99 , 100 ]. Moreover, reports concerning the predictive value of LH on miscarriage are distinct [ 93 , 101 , 102 ].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

Jacewicz-Święcka

Wołczyński

Kowalska

2021

JCM

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The knowledge of polycystic ovary syndrome (PCOS) natural history is limited. Our objective was to assess the effect of aging on clinical, hormonal and sonographic ovarian PCOS features and additionally to identify parameters that impact the course of PCOS. A secondary aim was to supply additional information on the reproductive outcome in women with previously diagnosed PCOS. A longitudinal cohort study with a median follow-up of 120.9 months was conducted, and 31 Caucasian women previously diagnosed with PCOS according to the Rotterdam criteria were re-examined at a median age of 35. Clinical examinations; transvaginal ultrasound scans; and lipid, E-selectin and sex hormone assessments were performed at the beginning and at the end of the follow-up. It was observed that menstrual cycles became regular and sonographic morphology of ovaries was normalized in 55% and 49% of the participants, respectively (all p < 0.05). At the final assessment, 55% of the women no longer met the criteria for PCOS (p < 0.05). The age, follicle-stimulating hormone (FSH) and E-selectin assessed at the baseline were the most important predictors of the PCOS persistence into later years (respectively, OR = 0.84, OR = 0.39, OR = 1.08, all p < 0.05). Ninety-five percent of the patients who had ever been trying to conceive became pregnant a minimum of once. The women with persistent PCOS had worse metabolic and reproductive parameters compared to the women with resolved PCOS. Positive correlations were found between the number of miscarriages and ovarian volume, LH, androstenedione, 17-hydroxyprogesterone and an increase in E-selectin during the follow-up (R = 0.46, R = 0.59, R = 0.54, R = 0.49, R = 0.47, all p < 0.05). In conclusion, progressing from the third to the fourth decade is connected with a reduction in PCOS features, which seems to have a great impact on fertility of women with a previous diagnosis of PCOS. FSH and E-selectin, as determined at the initial PCOS diagnosis, had an impact on the disappearance of the syndrome years after.

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Section: Discussionmentioning

confidence: 99%

The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

Jacewicz-Święcka

Wołczyński

Kowalska

2021

JCM

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“…Oxidative stress in response to saturated fat ingestion is an intermediate step in stimulating TNF- α secretion from circulating leukocytes [ 19 , 25 ]. In our investigations, we also showed that women with PCOS exhibit increased TNF-α synthesis [ 4 ]. Women with PCOS with normal and low levels of androgens measured by the level of testosterone and free androgen index (FAI) were more susceptible to the development of oxidative stress and inflammation induced by TNF-α [ 26 ].…”

Section: Introductionmentioning

confidence: 82%

“…Many studies have shown that higher hormone levels, gut microbiome composition, and plasma metabolomics are new parameters related to the PCOS phenotypes [ 4 ]. The clinical phenotypes can change over the life span with weight gain, and can coexist in the same patient.…”

Section: Introductionmentioning

confidence: 99%

Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review

et al. 2021

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Here we present an extensive narrative review of the broadly understood modifications to the lifestyles of women with polycystic ovary syndrome (PCOS). The PubMed database was analyzed, combining PCOS entries with causes, diseases, diet supplementation, lifestyle, physical activity, and use of herbs. The metabolic pathways leading to disturbances in lipid, carbohydrate, and hormonal metabolism in targeted patients are described. The article refers to sleep disorders, changes in mental health parameters, and causes of oxidative stress and inflammation. These conditions consistently lead to the occurrence of severe diseases in patients suffering from diabetes, the fatty degeneration of internal organs, infertility, atherosclerosis, cardiovascular diseases, dysbiosis, and cancer. The modification of lifestyles, diet patterns and proper selection of nutrients, pharmacological and natural supplementation in the form of herbs, and physical activity have been proposed. The progress and consequences of PCOS are largely modifiable and depend on the patient’s approach, although we have to take into account also the genetic determinants.

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“…Some recent studies have suggested that adverse pregnancy outcomes in PCOS patients may be related to menstrual patterns. A prospective cohort study showed that a HA + menstrual dysfunction + PCO phenotype is a risk factor for adverse pregnancy and neonatal outcomes, including gestational diabetes, pre-eclampsia, and reduced weight babies, in PCOS patients ( 25 , 26 ). A study of PCOS patients with normal menstrual cycle or oligomenorrhea and natural pregnancies showed that the risk of pregnancy complications in patients with PCOS may be affected by menstrual patterns, and the risk of pregnancy complications in patients with normal ovulation was similar to that of the normal population; however, no analysis was conducted among patients with PCOS who had amenorrhea.…”

Section: Discussionmentioning

confidence: 99%

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

Cao

et al. 2021

Front. Endocrinol.

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ObjectiveTo investigate the results of in vitro fertilization among polycystic ovary syndrome (PCOS) patients using the long-acting long protocol regarding the relationship between menstrual patterns and adverse pregnancy outcomes.DesignRetrospective cohort study.SettingUniversity-affiliated reproductive medical center.BackgroundThe menstrual patterns of patients with PCOS is considered related to metabolism; however, no study has analyzed the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in patients with PCOS who have different menstrual patterns. This study aimed to observe the outcomes of IVF/ICSI in patients with PCOS with different menstrual patterns who used the long-acting long protocol.MethodsThis was a retrospective analysis in the first cycle of IVF/ICSI at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019. In total, 1834 patients with PCOS were classified into the regular menstruation group (n=214), the oligomenorrhea group (n=1402), and the amenorrhea group (n=218).ResultsPCOS patients who used the long-acting long protocol of IVF/ICSI had similar clinical pregnancy rates and live birth rates despite having different menstrual patterns. The overall incidence of adverse pregnancy outcomes, including abortion, spontaneous preterm birth (sPTB), gestational diabetes(GDM), hypertensive disorder inpregnancy (HDP), and premature rupture of membranes(PROM, was significantly higher in the amenorrhea group than in the regular menstrual and oligomenorrhea groups (25.88% vs. 30.41% vs. 43.69%; P = 0.013). Additionally, the rates of GDM (2.35% vs. 6.10% vs. 13.79%; P=0.015) and macrosomia (5.26% vs. 10.94% vs. 18.39%; P=0.026) in the amenorrhea group were significantly higher than those in the other two groups. Correction for confounding factors showed that menstrual patterns are related to the occurrence of adverse pregnancy outcomes. Amenorrhea is an independent risk factor for adverse pregnancy outcome (OR [odds ratio]: 2.039, 95% CI [confidence interval]: 1.087-3.822), GDM (OR: 5.023, 95% CI: 1.083–23.289), and macrosomia (OR: 4.918, 95% CI: 1.516–15.954).ConclusionsIVF/ICSI can achieve similar pregnancy and live birth rates in PCOS patients with different menstrual patterns. However, the overall incidence of adverse pregnancy outcomes in PCOS patients with amenorrhea is higher than that in patients with regular menstruation or oligomenorrhea.

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Association between hyperandrogenism and adverse pregnancy outcomes in patients with different polycystic ovary syndrome phenotypes undergoing in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis

Cited by 23 publications

References 23 publications

The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

The Effect of Ageing on Clinical, Hormonal and Sonographic Features Associated with PCOS—A Long-Term Follow-Up Study

Nutrition Strategy and Life Style in Polycystic Ovary Syndrome—Narrative Review

Association Between Menstrual Patterns and Adverse Pregnancy Outcomes in Patients With Polycystic Ovary Syndrome

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