PCOS女性体外受精(IVF)/卵胞浆内单精子注射(ICSI)的卵巢刺激(OS)通常会导致多个卵泡发育,然而,有些人的反应较差或欠佳。关于卵巢反应不良/次优对PCOS妇女妊娠结局的影响的数据有限。
■这项研究的目的是评估PCOS女性的每个新鲜胚胎移植的活产率(LBR)和每个抽吸周期的累积活产率(CLBR)是否存在差异。以患者为导向的策略,包括个性化的卵母细胞数量(POSEIDON)标准。
对2011年1月至2020年12月在孙逸仙纪念医院接受首次IVF/ICSI周期的2,377名PCOS患者进行回顾性研究。根据年龄将患者分为四组,窦卵泡计数,和回收的卵母细胞数量,根据POSEIDON标准。比较这些组的LBR和CLBR。进行Logistic回归分析以评估POSEIDON标准是否为独立危险因素,并确定与POSEIDON相关的因素。
■对于<35岁的患者,POSEIDON和非POSEIDON患者的临床妊娠率没有显着差异,而POSEIDON患者的植入和活产率较低。POSEIDON组1a显示较低的植入率,临床妊娠,和活产。然而,POSEIDON组1b和非POSEIDON组的临床妊娠率和活产率无显著差异.对于年龄≥35岁的患者,植入率没有显著差异,临床妊娠,以及POSEIDON和非POSEIDON患者之间的活产。与非POSEIDON组相比,POSEIDON组1和2的CLBR显着降低。身体质量指数(BMI)的水平,卵泡刺激素(FSH),和窦卵泡计数(AFC)与POSEIDON低反应相关。POSEIDON被发现与较低的CLBR有关,但不是每个新鲜胚胎移植的LBR。
■在PCOS患者中,一个意想不到的次优反应可以实现一个公平的LBR每个新鲜胚胎移植。然而,POSEIDON患者每个抽吸周期的CLBR低于正常反应者。BMI,基础FSH水平,和AFC是与POSEIDON相关的独立因素。我们的研究为PCOS女性在对OS的意外不良/次优反应后的决策提供了数据。
UNASSIGNED: Ovarian stimulation (OS) for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in women with PCOS often results in multiple follicular development, yet some individuals experience poor or suboptimal responses. Limited data exist regarding the impact of poor/suboptimal ovarian response on pregnancy outcomes in women with PCOS.
UNASSIGNED: The aim of this study was to evaluate whether the live birth rate (LBR) per fresh embryo transfer and cumulative live birth rate (CLBR) per aspiration cycle differ in women with PCOS defined by the Patient-Oriented Strategy Encompassing IndividualizeD Oocyte Number (POSEIDON) criteria.
UNASSIGNED: A retrospective study involving 2,377 women with PCOS who underwent their first IVF/ICSI cycle at Sun Yat-sen Memorial Hospital from January 2011 to December 2020 was used. Patients were categorized into four groups based on age, antral follicle count, and the number of oocytes retrieved, according to the POSEIDON criteria. The LBR and CLBR were compared among these groups. Logistic regression analysis was performed to assess whether the POSEIDON criteria served as independent risk factors and identify factors associated with POSEIDON.
UNASSIGNED: For patients <35 years old, there was no significant difference in the clinical pregnancy rate between POSEIDON and non-POSEIDON patients, whereas POSEIDON patients exhibited lower rates of implantation and live birth. POSEIDON Group 1a displayed lower rates of implantation, clinical pregnancy, and live birth. However, no significant differences were observed in the rates of clinical pregnancy and live birth between POSEIDON Group 1b and non-POSEIDON groups. For patients ≥35 years old, there were no significant differences in the rates of implantation, clinical pregnancy, and live birth between POSEIDON and non-POSEIDON patients. CLBRs were significantly lower in POSEIDON Groups 1 and 2, compared with the non-POSEIDON groups. The levels of body mass index (BMI), follicle-stimulating hormone (FSH), and antral follicle count (AFC) were associated with POSEIDON hypo-response. POSEIDON was found to be associated with lower CLBR, but not LBR per fresh embryo transfer.
UNASSIGNED: In patients with PCOS, an unexpected suboptimal response can achieve a fair LBR per fresh embryo transfer. However, CLBR per aspirated cycle in POSEIDON patients was lower than that of normal responders. BMI, basal FSH level, and AFC were independent factors associated with POSEIDON. Our study provides data for decision-making in women with PCOS after an unexpected poor/suboptimal response to OS.