Corresponding author
Juanzi Shi, M.D., Ph.D.
Assisted Reproduction Center, Northwest Women and Children’s Hospital,
Xi’an, People’s Republic of China.
Mail: 73#, Houzaimen North Street, Xi’an, China
E-mail: shijuanziart@126.come
a Assisted Reproduction Center, Northwest Women and
Children’s Hospital, Xi’an, People’s Republic of China.
b Leuven Institute for Fertility & Embryology,
Schipvaartstraat 4, 3000 Leuven, Belgium.
Objective : To examine early and late pregnancy loss in women
with and without polycystic ovary syndrome (PCOS) undergoing IVF/ICSI
transfers.
Design: Retrospective cohort study.
Setting: Reproductive medicine center at a tertiary hospital.
Population: Records were reviewed for women with a positive
β-hCG after IVF/ICSI treatment from May 2014 to April 2019.
Methods: Odds ratios (ORs) for early (13 ≤weeks) and late
(13-24 weeks) pregnancy loss were calculated among women with and
without PCOS for plurality of the pregnancy with adjustment for
confounding factors.
Main outcomes measures: Early and late pregnancy loss.
Results : A total of 21,820 charts identified with a positive
β-hCG, 2,357 (10.8%) subjects had PCOS, and 19,463 (89.2%) controls
did not. Early pregnancy loss occurred in 12.4% of women with PCOS
versus 12.8% in women with non-PCOS. Women with PCOS demonstrated a
higher rate of late pregnancy loss (5.4% in PCOS vs 3.1% in non-PCOS,
OR 1.79, 95%CI, 1.46-2.19, P<.001), regardless of the
plurality of the pregnancy (one gestational sac: 4.1 vs. 2.7 percent, OR
1.56, 95%CI,1.18-2.05; ≥ two gestational sacs: 8.1 vs. 4.1 percent, OR
2.08, 95%CI,1.54-2.82, PCOS vs. Non-PCOS, respectively). Potential
negative impact of PCOS was reduced to marginal level once BMI were
taken into account (aOR 1.42, 95% CI, .99-2.03). BMI and maternal
comorbidities were independently associated with late pregnancy loss
(aOR 1.65, 95%CI, 1.26-2.17 and aOR 2.07,95%CI,1.43-3.00).
Conclusions : PCOS women with overweight and preexisting
comorbidities would benefit from lifestyle intervention and close
surveillance throughout the whole pregnancy.
Keywords : Polycystic ovary syndrome, pregnancy loss, vanishing
twins, overweight, comorbidity, pregnancy outcomes