Abstract
PurposeTo evaluate the association of endometrial thickness (EMT) with obstetric and neonatal outcomes in women with polycystic ovary syndrome (PCOS).MethodsA total of 1755 subfertile PCOS women with singleton livebirths after frozen-thawed embryo transfer were included between January 2009 and September 2019. Main obstetric outcomes were hypertensive disorders in pregnancy and abnormal placentation. Main neonatal outcomes were preterm birth (PTB), low birthweight (LBW) and small-for-gestational age (SGA). Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by univariate and multivariate logistic regression analyses.ResultsEach millimeter decrease in EMT was related to a 9% (adjusted OR 1.09, 95% CI 1.00–1.19; P = 0.053), 14% (adjusted OR 1.14, 95% CI 1.02–1.28; P = 0.002) and 22% (adjusted OR 1.22, 95% CI 1.07–1.38; P = 0.003) higher risk of PTB, LBW and SGA, respectively. Compared to women with EMT >13 mm, women with EMT ≤8 mm also had significantly higher risk of PTB (adjusted OR 3.79, 95% CI 1.53–9.39; P = 0.004), LBW (adjusted OR 4.33, 95% CI 1.39–13.50; P = 0.012) and SGA (adjusted OR 6.38, 95% CI 1.78–22.83; P = 0.004). These associations remained consistent in further subgroup analysis by endometrial preparation regimen and in sensitivity analyses among nulligravida women or women without adverse obstetric outcomes. No significant differences were found in the incidence of several pregnancy complications across EMT categories.ConclusionDecreased EMT was independently associated with increased risk of PTB, LBW and SGA in women with PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 4–21% of reproductive-aged women worldwide [1]
Each millimeter decrease in endometrial thickness (EMT) was related to a 9%, 14% and 22% higher risk of preterm birth (PTB), low birthweight (LBW) and small-for-gestational age (SGA), respectively
Compared to women with EMT >13 mm, women with EMT ≤8 mm had significantly higher risk of PTB, LBW and SGA
Summary
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 4–21% of reproductive-aged women worldwide [1]. This heterogeneous syndrome is the major cause of female anovulatory infertility and is associated with increased risk of complications during pregnancy and perinatal period [2,3,4]. The expression of endometrial receptivity markers, including avb integrin, homeobox A10 and insulin-like growth factor-binding protein 1, is decreased in the window of implantation [14,15,16] Whether these markers predict clinical outcomes in PCOS women is still poorly investigated [8]
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