■众所周知,雄激素过量会损害卵母细胞的质量,子宫内膜容受性甚至胚胎侵入。强烈建议游离雄激素指数(FAI)评估活性雄激素。先前的研究显示,关于多囊卵巢综合征(PCOS)患者高雄激素血症对妊娠结局的影响,结论相互矛盾。本研究旨在分析基于FAI的高雄激素血症对PCOS患者冷冻胚胎移植(FET)结局的影响。
■在2017年1月至2022年4月期间接受首次FET的PCOS患者使用FAI分层为两组。一个高度推荐的参数:PCOS伴高雄激素血症(n=73)和PCOS不伴高雄激素血症(n=255)。采用Student\'st检验或卡方(χ2)统计量分析基础和不孕症特征。进行Logistic回归分析以验证FAI是否有助于预测PCOS妇女的妊娠结局。
■身体质量指数(BMI),总促性腺激素(Gn),基础血清卵泡刺激素(bFSH),基础血清睾酮(bT),性激素结合球蛋白(SHBG),两组间FAI差异有统计学意义。(分别为P=0.005,P<0.001,P<0.001,P<0.001和P<0.001)。然而,临床妊娠,堕胎,和活产没有显着差异。进一步的回归分析显示,FAI与临床妊娠无关,流产,或活产率(调整后比值比(OR)=0.978,95%置信区间(CI)=0.911-1.050,P=0.539;调整后OR=1.033,95%CI=0.914-1.168,P=0.604;调整后OR=0.976,95%CI=0.911-1.047,P=0.499).
■FAI与PCOS患者的妊娠结局无关;也就是说,它没有反映高雄激素血症对PCOS患者妊娠结局的任何负面影响,也不是一个提供信息的临床参数.因此,应更多关注影响FAI反映体内雄激素水平准确性的因素,需要进一步讨论。
UNASSIGNED: It is well known that androgen excess impairs oocyte quality, endometrial receptivity and even embryo invasion to some extent. Free androgen index (
FAI) is strongly recommended to evaluate active androgen. Previous studies have showed conflicting conclusions on the effect of hyperandrogenism on the pregnancy outcomes in patients with polycystic ovary syndrome (PCOS). This
study aims to analyze the influence of hyperandrogenemia based on
FAI on frozen embryo transfer (FET) outcomes in patients with PCOS.
UNASSIGNED: Patients diagnosed with PCOS who underwent their first FET between January 2017 and April 2022 were stratified into two cohorts using
FAI, a highly recommended parameter: PCOS with hyperandrogenemia (n=73) and PCOS without hyperandrogenemia (n=255). Basic and infertility characteristics were analyzed using Student\'s t-test or chi-square (χ2) statistics. Logistic regression analysis was performed to verify whether
FAI was helpful in predicting pregnancy outcomes in women with PCOS.
UNASSIGNED: Body mass index (BMI), total gonadotropin (Gn), basal serum follicle-stimulating hormone (bFSH), basal serum testosterone (bT), sex hormone binding globulin (SHBG), and FAI were significantly different between the two groups. (P=0.005, P<0.001, P<0.001, P<0.001, and P<0.001, respectively). However, clinical pregnancies, abortions, and live births did not differ significantly. Further regression analyses showed that
FAI was not related to clinical pregnancy, abortion, or live birth rates (adjusted odds ratio (OR)=0.978, 95% confidence interval (CI)=0.911-1.050, P=0.539; adjusted OR=1.033, 95% CI=0.914-1.168, P=0.604; and adjusted OR=0.976, 95% CI=0.911-1.047, P=0.499, respectively).
UNASSIGNED: FAI was not associated with pregnancy outcomes in patients with PCOS; that is, it did not reflect any negative effects of hyperandrogenemia on pregnancy outcomes in patients with PCOS and was not an informative clinical parameter. Therefore, more attention should be paid to the factors that influence the accuracy of FAI in reflecting androgen levels in vivo, and further discussion is needed.