The following is a summary of the “Risk factors for clinical pregnancy loss after IVF in women with PCOS,” published in the January 2023 issue of Reproductive Biomedicine Online by Wang, et al.

Women with polycystic ovary syndrome (PCOS): a case-control study nested within a multicenter randomized trial comparing the success of fresh versus frozen embryo transfer in achieving a live birth. The case group comprises women who experienced a clinical pregnancy loss, while the control group comprises women who successfully gave birth. They compared variables before IVF treatment, during ovarian stimulation, and after embryo transfer. 

Higher maternal BMI (P = 0.010), anti-Müllerian hormone (P = 0.032), 2-h glucose concentration after 75 g oral glucose tolerance test (OGTT), and proportion of fresh embryo transfers (P = 0.001) were associated with clinical pregnancy loss in women. Clinical pregnancy loss in polycystic ovary syndrome (PCOS) may be affected differently by factors such as antral follicle count (AFC; P = 0.013) and 2-h glucose concentration after oral glucose tolerance test (OGTT; P = 0.024).

Adjusted odds ratio (aOR) for clinical pregnancy loss due to AFC was 1.03 (95% CI 1.01-1.05) after fresh embryo transfer, and aOR for clinical pregnancy loss due to 2-hour glucose concentration after oral glucose tolerance test (OGTT) was 1.13 (95% CI 1.01-1.25) after frozen embryo transfer (FET) cycles. Clinical pregnancy loss was associated with fresh embryo transfer, increased body mass index, abnormal fasting concentrations, and 2-hour glucose concentrations after oral glucose tolerance tests in women with polycystic ovary syndrome. FET may be the best option to reduce the risk of clinical pregnancy loss, especially for those with higher AFC. Close monitoring is warranted during FET due to an apparent correlation between 2-h glucose after OGTT and clinical pregnancy loss.

Source: sciencedirect.com/science/article/abs/pii/S1472648322007544