Independent Variables for Determining the Cumulative Live Birth Rates of Aged Patients with Polycystic Ovary Syndrome or Tubal Factor Infertility: A Retrospective Cohort Study

Abstract

ObjectiveTo assess whether women of advanced age (≥35 years) with polycystic ovary syndrome (PCOS) have the same cumulative live birth rate (CLBR) as their age-matched controls with tubal factor infertility and to determine the influencing factors on the CLBRs of aged women.DesignA retrospective cohort study.Setting and PopulationA total of 160 women of advanced age (≥35 years) with PCOS and 1073 women with tubal factor infertility were included in our study. All patients underwent their first fresh cycles and subsequent frozen cycles within in one year in our centre from 2015 to 2020.MethodsTo determine independent influencing factors on the CLBRs of these aged patients, a multivariable Cox regression model of CLBR according to the transfer cycle type was constructed. Main outcome measure(s): CLBRs.ResultThe Cox regression model of the CLBRs indicated that there was no significant difference between the PCOS group and the tubal infertility group in terms of advanced age (HR, 0.95; 95% CI, 0.71-1.27, P=0.732). The CLBR significantly decreased for women of advanced reproductive age up to 37 years of age (HR, 0.46; 95% CI, 0.39-0.56, P<0.001). The CLBR increased by 63% when more than ten oocytes were retrieved (HR, 1.63; 95% CI, 1.34-1.98, P<0.001). Patients with an AMH level above 32.13pmol/l were likely to have a 72%(HR, 1.72; 95% CI, 1.08-2.73, = 0.023) and 34% (HR, 1.34; 95% CI, 1.07-1.68, P=0.010)improvement in CLBR compared to those with an AMH below 7.85pmol/l and 7.85-32.12pmol/l, respectively.ConclusionDespite the higher number of oocytes retrieved in PCOS patients, the reproductive window is not extended for PCOS patients compared with tubal factor infertility patients. Age, AMH and the number of oocytes retrieved play crucial roles in the CLBRs of patients of advanced age (≥35 years).

Association of the Cumulative Live Birth Rate with the Factors in Assisted Reproductive Technology: A Retrospective Study of 16,583 Women

“…Recently, a retrospective study with a large sample size pointed out that AMH highly correlates with the CLBR in women with diminished ovarian reserves (DOR) independent of age [ 14 ]. The similar result was found in a population of elderly women [ 38 ]. Low AMH levels have been reported to have a negative effect on live birth in women undergoing ART [ 29 , 39 , 40 , 41 ].…”

Higher Cumulative Live Birth Rate but Also Higher Late Miscarriage Risk in Non-Obese Women with Polycystic Ovary Syndrome Undergoing the First IVF/ICSI Cycle

“… 31 , 32 Numerous studies consistently report that the CLBR among PCOS patients exceeds that of control groups, 33 , 34 even in women aged ≥ 35. 35 , 36 Our findings align with prior research, reinforcing the notion that PCOS patients achieve higher CLBR than their non-PCOS counterparts. Obesity is recognized for its adverse impact on oocyte quantity and quality, as well as reduced endometrial receptivity, 37 , 38 ultimately influencing embryo implantation and clinical pregnancy rates.…”

Association between serum AMH levels and IVF/ICSI outcomes in patients with polycystic ovary syndrome: a systematic review and meta-analysis

“…However, among women with tubal factor infertility, AMH had a moderate predictive value for a live birth (AUC = 0.70 [95% CI, 0.55 to 0.85]). Guan et al [ 28 ] analyzed the cumulative live birth rate in 160 PCOS patients of advanced age (≥ 35 years). All patients underwent their first fresh cycles and subsequent frozen cycles within one year.…”