Effect of baseline LH/FSH ratio in PCOS on IVF-ET outcomes:a retrospective cohort study
Objective To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone(LH/FSH)ratio of polycystic ovary syndrome(PCOS)and in vitro fertilisation-embryo transfer outcomes.Methods This was a retrospective cohort study.A total of 2 868 PCOS patients were enrolled,all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021.Propensity score matching(1:2.5)was conducted to regulate the non-random allocation of patients.Data were extracted from the hospital's medical records.Patients with baseline LH/FSH ratio＞2 were deemed as study group,patients with baseline LH/FSH ratio≤2 were deemed as control group.Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups.Results After propensity score matching(1:2.5),there were no statistically significant differences in baseline data between the two groups(all P＞0.05),indicating that the data were comparable.In the study group,the total dose of gonadotropin(Gn)and duration of Gn were lower than those of the control group(t=4.989,P＜0.001;t=3.267,P=0.001),the rate of in vitro maturation was higher than that of the control group(x2=4.938,P=0.026),the number of retrieved oocytes and cleavage were higher than those of the control group(t=-2.305,P=0.021;t=-2.816,P=0.005),but there were no differences in the number and rate of high-quality embryos between the two groups(t=-1.636,P=0.102;t=-0.123,P=0.902).The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group(x2=17.277,P＜0.001).Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles,the incidences of gestational diabetes mellitus in the study group were higher than those in the control group(x2=9.174,P=0.002;x2=4.204,P=0.040)of singleton pregnancy.In the fresh embryo transfer cycle,the clinical pregnancy rate[30.30％(20/66)vs 47.75％(53/111)]and delivery rate[30.30％(20/66)vs 46.85％(52/111)]in the study group were lower than those in the control group(x2=5.198,P=0.023;x2=4.695,P=0.030).In the frozen-thawed embryo transfer cycle,the delivery rate in the study group was higer than that in the control group[59.41％(423/712)vs 55.04％(1 053/1913);x2=7.526,P=0.023].The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle(x2=21.308,P＜0.001;x2=20.871,P＜0.001),but there were no significant differences in the control group(all P＞0.05).Conclusions PCOS patients with a higher basal LH/FSH ratio are more likely to develop moderate to severe ovarian hyperstimulation syndrome after controlled ovarian stimulation and have a higher incidence of gestational diabetes mellitus.Better pregnancy outcome could be obtained by frozen-thawed embryo transfer.
万方数据
维普
