Abstract
Research question
Which patient features predict the time to pregnancy (TTP) leading to term live birth
in infertile women diagnosed with polycystic ovary syndrome (PCOS)?
Design
Prospective cohort follow-up study was completed, in which initial standardized phenotyping
was conducted at two Dutch university medical centres from January 2004 to January
2014. Data were linked to the Netherlands Perinatal Registry to obtain pregnancy outcomes
for each participant. All women underwent treatment according to a standardized protocol,
starting with ovulation induction as first-line treatment. Predictors of pregnancies
(leading to term live births) during the first year after PCOS diagnosis were evaluated.
Results
A total of 1779 consecutive women diagnosed with PCOS between January 2004 and January
2014 were included. In the first year following screening, 659 (37%) women with PCOS
attained a pregnancy leading to term birth (≥37 weeks of gestational age). A higher
chance of pregnancy was associated with race, smoking, body mass index (BMI), insulin,
total testosterone and sex hormone-binding globulin (SHBG) concentrations (c-statistic = 0.59).
Conclusions
Predictors of an increased chance of a live birth include White race, no current smoking,
lower BMI, insulin and total testosterone concentrations, and higher SHBG concentrations.
This study presents a nomogram to predict the chances of achieving a pregnancy (leading
to a term live birth) within 1 year of treatment.
Keywords
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Biography
Marlise Gunning obtained her MD, PhD and MSc in Clinical Epidemiology from the University of Utrecht. She currently works as a MD in OBGYN. Dr Gunning is active as Junior Deputy of the ESHRE's Special Interest Group for Reproductive Endocrinology and also serves on the Scientific Organizer Committee for this group.
Key message
Within 1 year of treatment, 37% of women with PCOS attain a pregnancy leading to term live birth. White race, non-smoking, low BMI, insulin and testosterone, and high SHBG predict this outcome. A nomogram is presented that predicts the likelihood of this outcome, which may allow for improvements in individualized treatment strategies.
Article info
Publication history
Published online: October 05, 2022
Accepted:
September 28,
2022
Received in revised form:
September 26,
2022
Received:
August 9,
2022
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2022 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
