The Prevalence and Impact of Polycystic Ovary Syndrome in Recurrent Miscarriage: A Retrospective Cohort Study and Meta-Analysis

Abstract

Background: The use of different definitions and diagnostic approaches of polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM) has led to a wide range of prevalence rates in the literature. Despite the persistent controversy about the factual prevalence of PCOS in RM, a vast number of studies have revealed evidence about their association with each other. The goals of this study were to evaluate the prevalence of polycystic ovarian morphology and PCOS within the RM population, performing meta-analyses with the obtained data from this study, together with previous reports on this topic and evaluating reproductive outcome in women with RM and PCOS. Methods: A retrospective cohort study with 452 women with RM and a meta-analysis were conducted. The main outcome parameter was the prevalence of PCOS in RM patients. Results: In the retrospective study, the prevalence of PCOS in RM was 9.5%. Negative results for the selected risk factors for RM were present in 283 patients (62.6%). From all evaluated possible underlying causes for RM, only the presence of thrombophilic disorders was significantly associated with PCOS (PCOS: 20.9% versus no PCOS: 7.8%, p = 0.010). In the meta-analysis of three studies on PCOS in RM patients, which used the revised Rotterdam criteria for defining PCOS, an estimated pooled prevalence of 14.3% (95% CI: 6.2–24.9) was found. In the retrospective data set, women in the PCOS group revealed significantly higher luteinizing hormone (LH), testosterone, and Anti-Mullerian hormone (AMH) levels than age- and body mass index (BMI)-matched controls with RM negative for the selected risk facotrs (p < 0.05). The rate of further miscarriages was significantly higher in PCOS women than in controls (71.4% versus 53.6%, respectively; p = 0.031). Conclusions: The prevalence of PCOS seems slightly increased in women with RM. Women with PCOS suffering from RM showed a significantly higher risk for further miscarriage and decreased chances of having a life birth of about 18% which did not reach statistical significance. Therefore, we assume that PCOS plays a moderate role in RM.

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

“…Furthermore, positive correlations were found between the number of miscarriages and OVol, 17-OHP, A4 and LH, suggesting that the women with PCOM and elevated adrenal androgens can be at a higher risk of miscarriages compared to the women with a previous diagnosis of PCOS but no features of PCOM or adrenal HA. Unless it has been proved that PCOS may independently from BMI increase the risk of miscarriage [ 50 , 90 , 91 ], the direct causes of this implication are poorly recognized. Several potential risk factors of miscarriages in PCOS have been described.…”

Correlation of Polycystic Ovary Syndrome and Recurrent Miscarriage

“…In this study we found that the prevalence of PCO was 18 (19.1%) with RM. Mayrhofer et al (4) found that PCOS was found in 43 (9.5%) of all women. Rai et al (8) found that the prevalence of polycystic ovarian morphology amongst women with recurrent miscarriage was 40.7% (895/2199).…”

“…Polycystic ovarian syndrome (PCOS) is a clinically and biochemically heterogeneous disorder. It is the most common endocrinopathy in reproductive aged women affecting 4%-12% (4) . Numerous studies have investigated the association between PCOS and RM.…”

Yoga Effects on Anthropometric Indices and Polycystic Ovary Syndrome Symptoms in Women Undergoing Infertility Treatment: A Randomized Controlled Clinical Trial

“…Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women in their reproductive age and the prevalence of this syndrome varies from 6.5 to 19.9% in the world [ 1 , 2 ]. According to the latest systematic review studies, the prevalence of this syndrome is estimated at 3% according to the definition provided by the National Institutes of Health (NIH) and at 7% according to the definition provided by Rotterdam in Iran [ 3 ].…”