Pregnancy Outcome Of Polycystic Ovary Syndrome Patients After IVF-ET

Objective Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterised by chronic anovulation, hyperandrogenism and polycystic ovaries on ultrasound. Patients commonly show features of metabolic syndrome and insulin resistance. This study was to analyze the pregnancy outcomes of polycystic ovary syndrome (PCOS) patients after in vitro fertilization and embryo transfer (IVF-ET), to find out whether various phenotypes of PCOS which were diagnosed following the 2003 Rotterdam Consensus criteria had different adverse obstetric risks or neonatal outcomes and to investigate the differences of pregnancy outcomes between the obese PCOS patients and non-obese ones.Methods Retrospective study was carried out between 631 PCOS patients and 1423 women as controls (because of tubal factor) after IVF-ET. The PCOS patients and controls had matched age and body mass index (BMI). Data of pregnancy loss, gestational complication, gestation days at birth, newborn number, birth weight of singleton term newborn, rate of small/large for gestational age infant(SGA/LGA) and malformation were compared.Results PCOS patients had a significantly higher abortion rate (22.7% vs.18.7%, p<0.05) and preterm birth rate (11.2% vs.6.4%, p<0.05). There was no difference between PCOS patients and controls in other aspects. Ovulatory PCOS patients had similar abortion rate and preterm birth rate to controls. Conversely, oligo-ovulatory PCOS patients showed higher abortion rate and preterm birth rate than the controls. The phenotype of PCOS patients without PCO morphous on ultrasound (i.e. non-PCO PCOS) showed higher risk compared with other phenotypes. The obese PCOS patients demonstrated higher abortion rate (28.9% vs.20.4%,p=0.025),higher risk of developing pregnancy-induced hypertension(PIH) for single mothers. The mean weight of singleton babies for obese mothers were heavier (3.6±0.7 vs.3.4±0.5 kg, p=0.017).The obese PCOS mothers showed a significantly higher prevalence of LGA newborns (24.1% vs.7.9%,p<0.001) compared with non-obese PCOS patients.Conclusions PCOS patients after IVF-ET had an increased abortion rate and preterm birth rate. There was no significant difference between ovulatory PCOS patients and the controls. Non-PCO PCOS patients had worse pregnancy outcome. Ovarian dysfunction may be related to increased adverse obstetric risks and neonatal outcomes. The obese PCOS patients were at increased risk of pregnancy and neonatal complications.