DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222301
Published: 2022-08-29

Pregnancy outcomes in the in vitro fertilization conceived polycystic ovary syndrome patients: a prospective study

Ruksar Golandaz, Sneha Mishra, Shruti Gupta

Abstract


Background: In vitro fertilization (IVF) is the need of modern era which was first developed to overcome the infertility resulting from irreparable tubal disease but now is applied more broadly for treatment of all causes of infertility including polycystic ovary syndrome (PCOS) and is associated with obstetric complications as well. This study aimed to whether pregnancy-related outcomes and complications are differed between patients with polycystic ovary syndrome (PCOS) and those with other causes of infertility who had undergone IVF. Objective were to compare maternal and fetal outcome in IVF conceived women with PCOS v/s without PCOS. Prospective comparative study at a tertiary care hospital.

Methods: After getting approval from institutional ethical and scientific research committee, 108 IVF conceived women are studied, where IVF is done using controlled ovarian stimulation with GnRH antagonist protocol followed by freeze all strategy and preparation of endometrial lining. Frozen embryo transfer done in subsequent cycle over a period of one year. Study group includes women with PCOS and control group includes women without PCOS. The entire data is statistically analysed using statistical package for social sciences (SPSS ver 22.0, IBM Corporation, USA) for MS Windows.

Results: Out of 108 IVF conceived pregnant women studied, 50% were PCOS (study group) and 50% non PCOS (control group). We have compared maternal and neonatal outcome in both the groups which shows patient in PCOS group has higher incidence of GDM, severe pre-eclampsia, preterm labour, LBW babies, SGA babies and babies admitted to NICU.

Conclusions: Women with PCOS should be given notice of additional adverse pregnancy outcomes as well receiving early diagnosis and treatment for these complications during pregnancy and postpartum period.


Keywords


PCOS, IVF, COS, Maternal outcome, Fetal outcome

Full Text:

PDF

References


Pandey S, Shetty A, Hamilton M, Bhattacharya S, Maheshwari A. Obstetric and perinatal outcomes in singleton pregnancies resulting from IVF/ICSI: a systematic review and meta-analysis. Hum Reprod Update. 2012;18:485-503.

Helmerhorst FM, Perquin DA, Donker D, Keirse MJ. Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies. BMJ. 2004;328:261.

Homburg R, Crawford G. The role of AMH in anovulation associated with PCOS: a hypothesis. Human reproduction (Oxford., England). 2014;29:1117-21.

Wild RA. Long term health complications of PCOS. Hum Reprod Update. 2002;8(3):231-1.

Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010.

Azziz R, Carmina E, Dewailly D, Diamanti Kandarakis E, Escobar-Morreale HF, Futterweit W et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metabol. 2006;91:4237-45.

Sha T, Wang X, Cheng W, Yan Y. A meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF. Reproductive Biomed Online. 2019;39(2):281-93.

Tandulwadkar S, Lodha P, Mangeshikar NT. Obstetric complications in women with IVF conceived pregnancies and polycystic ovarian syndrome. India J Hum Reprod Sci. 2014;7(1):13-8.

Roos N, Kieler H, Sahlin L, Ekman-Ordeberg G, Falconer H, Stephansson O. Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ. 2011;343:6309.

Haakova L, Cibula D, Rezabek K, Hill M, Fanta M, Zivny J. Pregnancy outcome in women with PCOS and in controls matched by age and weight. Human Reproduct (Oxford, England). 2003;18(7):1438-41.

Wang Y, Zhao X, Zhao H, Ding H, Tan J, Chen J et al. Risks for gestational diabetes mellitus and pregnancy-induced hypertension are increased in polycystic ovary syndrome. BioMed Res Int. 2013;2013:182582.

Bagegni NA, Blaine J, Van Voorhis BJ, Dokras A. Risk of early and late obstetric complications in women with IVF- conceived pregnancies and polycystic ovary syndrome (PCOS). Proceedings Obstetr Gynecol. 2010;1(2):1-10.

Palomba S, Santagni S, Falbo A, La Sala GB. Complications and challenges associated with polycystic ovary syndrome: current perspectives. Int J Women’s Health. 2015;7:745-63.

Mikola M, Hiilesmaa V, Halttunen M, Suhonen L, Tiitinen A. Obstetric outcome in women with polycystic ovarian syndrome. Human Reproduction (Oxford, England). 2001;16(2):226-9.

Bjercke S, Dale PO, Tanbo T, Storeng R, Ertzeid G, Abyholm T. Impact of insulin resistance on pregnancy complications and outcome in women with polycystic ovary syndrome. Gynecolog Obstetr Investigation. 2002;54(2):94-8.

Boomsma CM, Eijkemans MJC, Hughes EG, Visser GHA, Fauser BCJM, Macklon NS. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Human Reproduction Update. 2006;12(6):673-83.

Qin JZ, Pang LH, Li MJ, Fan XJ, Huang RD, Chen HY. Obstetric complications in women with polycystic ovary syndrome: a systematic review and Meta-analysis. Reproduct Biol Endocrinol. 2013;11(1).

Han AR, Kim HO, Cha SW, Park CW, Kim JY, Yang KM et al. Adverse pregnancy outcomes with assisted reproductive technology in non-obese women with polycystic ovary syndrome: a case-control study. Clin Exp Reproduct Med. 2011;38(2):103-8.

Yamamoto M, Feigenbaum SL, Crites Y, Escobar GJ, Yang J, Ferrara A, Lo JC. Risk of preterm delivery in non-diabetic women with polycystic ovarian syndrome. J Perinatol. 2012;32(10):770-76.

Mulders AG, Laven JS, Imani B, Eijkemans MJ, Fauser BC. IVF outcome in anovulatory infertility (WHO group 2)-including polycystic ovary syndrome-following previous unsuccessful ovulation induction. Reproduct biomed online. 2003;7:50-8.

Kuivasaari-Pirinen P, Hippelainen M, Hakkarainen H, Randel K, Heinonen S. Cumulative baby take-home rate among women with PCOS treated by IVF. Gynecol Endocrinol. 2010;26:582-9.

Swanton A, Storey L, McVeigh E, Child T. IVF outcome in women with PCOS, PCO and normal ovarian morphology. Euro J Obstetr Gynecol Reproduct Biol. 2010;149:68-71.

Zhang XYW, Wang ZL, Jia MX, Wang ZY, Yuan Y, Zhou CQ. Pregnancy Outcomes of Patients with Polycystic Ovary Syndrome after IVF and Embryo Transfer. J Sun Yat-Sen University. 2013;34:596-600.

Azizia M, Hardiman P. Complications of pregnancy in women with polycystic ovarian syndrome. Fetal Maternal Med Rev. 2011;22(3):188-206.