Reproductive prognosis factors in women with infertility and polycystic ovary syndrome undergoing in vitro fertilization techniques

不孕症和多囊卵巢综合征女性接受体外受精技术后的生殖预后因素

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Abstract

OBJECTIVE: Polycystic ovary syndrome (PCOS) is the most prevalent endocrinopathy and is often associated with elevated levels of anti-Müllerian hormone (AMH) and obesity. AMH may influence the reproductive prognosis of women undergoing in vitro fertilization (IVF). This study aims to explore fundamental reproductive characteristics and intra-cycle variables related to IVF and their association with reproductive success in women with PCOS. METHODS: This retrospective study involved 393 women with PCOS who underwent IVF. It was designed to evaluate the relationship between AMH levels, body mass index (BMI), age, and the luteinizing hormone/follicle-stimulating hormone (LH:FSH) ratio, along with reproductive outcomes. The sample was categorized based on AMH percentiles, BMI classes, age, and LH:FSH ratio. RESULTS: A negative correlation was observed between AMH levels and age. There were no significant differences in BMI across AMH groups, except in the very high AMH group, where women were found to be overweight. The LH:FSH ratio increased with AMH levels. Notably, women over the age of 35 with elevated AMH levels exhibited lower live birth rates (LBR) and cumulative live birth rates (CLBR) compared to their younger counterparts within the same AMH percentile range. A decrease in the fertilization rate was noted among overweight women. CONCLUSIONS: While AMH measurement may assist in clinical decision-making, it should not be regarded as a sole predictor of IVF success. Age appears to have a more substantial impact on LBR compared to BMI. In practice, CLBR is the most informative metric to convey reproductive success to couples. Variations in results among studies could be attributed to differences in populations, sample sizes, and inconsistencies in the definitions of LBR and CLBR.

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