Objective To investigate the risk factors for infertility in obese patients with polycystic ovary syndrome(PCOS)to provide more effective treatment strategies and preventive measures.Methods A total of 126 PCOS patients with infertility who visited Shangrao Maternal and Child Health Hospital from March 2020 to March 2023 were selected as the PCOS group.Additionally,102 healthy volunteers undergoing physical examination during the same period were selected as the control group.General clinical data were collected through questionnaires,and infertility-related stress levels were assessed using the Fertility Problem Inventory(FPI).The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate sleep disorders.Serum inhibin B(INHB)and anti-Müllerian hormone(AMH)levels were measured by enzyme-linked immunosorbent assay(ELISA),while follicle-stimulating hormone(FSH),luteinizing hormone(LH),progesterone,estradiol(E2),testosterone(T),and sex hormone-binding globulin(SHBG)were determined by electrochemiluminescence.The number of follicles on both sides was calculated using color Doppler ultrasound.Multivariate logistic regression analysis was used to identify risk factors for infertility in obese PCOS patients.Results There were no statistically significant differences in general clinical data between the two groups(P＞0.05).However,significant differences were found between the two groups in body mass index(BMI),sleep disorders,fertility stress,number of follicles on both sides,levels of INHB,AMH,FSH,LH,progesterone,E2,T,and SHBG(P＜0.05).Multivariate logistic regression analysis revealed that BMI[OR=1.272(95％CI:1.153,1.402)],sleep disorders[OR=3.191(95％CI:2.045,4.978)],fertility stress[(O)R=1.021(95％CI:1.014,1.027)],number of follicles in the left ovary[(O)R=1.092(95％CI:1.006,1.186)],number of follicles in the right ovary[(O)R=1.160(95％CI:1.074,1.252)],INHB[(O)R=1.007(95％CI:1.001,1.013)],AMH[(O)R=1.138(95％CI:1.032,1.256)],LH[(O)R=1.190(95％CI:1.115,1.271)],and T[(O)R=1.304(95％CI:1.173,1.450)]were independent risk factors for infertility in obese PCOS patients(P＜0.05).Conversely,FSH[(O)R=0.762(95％CI:0.670,0.867)],progesterone[(O)R=0.624(95％CI:0.463,0.841)],E2[(O)R=0.994(95％CI:0.988,1.000)],and SHBG[(O)R=0.977(95％CI:0.956,0.999)]were protective factors(P＜0.05).The area under the receiver operating characteristic(ROC)curve for the model was 0.972(95％CI:0.951,0.993),with a sensitivity of 96.83％(95％CI:0.913,0.991)and a specificity of 94.3％(95％CI:0.813,0.971),indicating a good fit for the regression model.Conclusion The risk factors for infertility in obese PCOS patients include high BMI,sleep disorders,high fertility stress,increased follicle count on both sides,levels of INHB,AMH,FSH,and LH,while progesterone,E2,and SHBG serve as protective factors.
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