Pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization

Lynn Sterling; Jennifer Liu; Nan Okun; Anamika Sakhuja; Sony Sierra; Ellen Greenblatt

doi:10.1016/j.fertnstert.2015.11.019

Pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization

Fertil Steril. 2016 Mar;105(3):791-797.e2. doi: 10.1016/j.fertnstert.2015.11.019. Epub 2015 Dec 2.

Authors

Lynn Sterling¹, Jennifer Liu², Nan Okun³, Anamika Sakhuja², Sony Sierra⁴, Ellen Greenblatt⁵

Affiliations

¹ Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada. Electronic address: lynn.sterling@utoronto.ca.
² Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.
³ Department of Maternal-Fetal Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
⁴ Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada; LifeQuest Centre for Reproductive Medicine, Toronto, Ontario, Canada.
⁵ Centre for Fertility and Reproductive Health, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.

PMID: 26654973
DOI: 10.1016/j.fertnstert.2015.11.019

Abstract

Objective: To determine whether the diagnosis of polycystic ovary syndrome (PCOS) independently predicts increased rates of pregnancy complications relative to control subjects, after adjusting for important confounders.

Design: Retrospective cohort.

Setting: Not applicable.

Patient(s): A review of all pregnancies after fresh IVF with or without intracytoplasmic sperm injection transfers from December 2006 to 2012 (n = 1,084) identified 394 eligible singleton births (71 women with PCOS; 323 controls without).

Intervention(s): Not applicable.

Main outcome measure(s): Singleton births were assessed for selected adverse pregnancy and birth outcomes.

Result(s): Women with PCOS demonstrated a higher risk of developing the following pregnancy complications after adjusting for differences in age, parity, body mass index, and time to conception: gestational diabetes (adjusted odds ratio [AOR] 3.15, 95% confidence interval [CI] 1.35-7.33), hypertensive disorders of pregnancy (AOR 4.25, 95% CI 1.94-9.32), preterm birth <37 weeks (AOR 2.30, 95% CI 1.07-4.97), and large for gestational age >90th percentile (AOR 2.77, 95% CI 1.21-6.35). The increased risk of preterm birth <37 weeks was eliminated after adjusting for development of hypertensive disorders of pregnancy, whereas the increased risk of large for gestational age remained significant after adjusting for gestational diabetes mellitus status. Time to conception did not differ significantly between groups, nor did rates of antepartum hemorrhage, cesarean section, or perinatal mortality.

Conclusion(s): Polycystic ovary syndrome independently predicts higher risk of adverse pregnancy outcomes after adjusting for differences in maternal age, parity, body mass index, and time to conception. This new information may be of relevance in counseling and monitoring women with PCOS, although larger prospective studies may be needed to validate our findings.

Keywords: Diabetes (gestational); hypertension (pregnancy-induced); in vitro fertilization; polycystic ovary syndrome; pregnancy outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Chi-Square Distribution
Female
Fertility
Fertilization in Vitro* / adverse effects
Humans
Infertility, Female / diagnosis
Infertility, Female / etiology
Infertility, Female / physiopathology
Infertility, Female / therapy*
Live Birth
Logistic Models
Multivariate Analysis
Odds Ratio
Polycystic Ovary Syndrome / complications*
Polycystic Ovary Syndrome / diagnosis
Pregnancy
Pregnancy Complications / etiology
Pregnancy Rate
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome