Prediction of clinical pregnancy after in vitro fertilisation-embryo transfer in infertile patients with polycystic ovary syndrome

Abstract

Background Polycystic ovary syndrome (PCOS) affects a patient's ovarian function and reduces a patient's fertility. This study aimed to evaluate predictors of clinical pregnancy after in vitro fertilisation-embryo transfer (IVFET) in infertile PCOS patients.

Methods The study included infertile patients with PCOS who received IVF-ET from January 2017 to March 2024 at the Reproductive Medicine Center of the General Hospital of Northern Theater Command. This study analysed the predictors of clinical pregnancy after IVF-ET in infertile patients with PCOS and analysed the predictive effect of these factors on clinical pregnancy.

Results A total of 425 patients with PCOS who met the criteria were included in the study. Multivariate logistic regression analysis found that luteinising hormone (LH)/follicle-stimulating hormone (FSH) (OR =0.577, $95\mathrm{\%}\mathrm{C}\mathrm{I}0.422$95%CI0.422 to 0.789;p=0.001 ), free thyroxine (FT4) level ( $0\mathrm{R}=\mathrm{1.107,95}\mathrm{\%}\mathrm{C}\mathrm{l}1.009$0R=1.107,95%Cl1.009 to 1.214; p=0.031 ), number of embryos transferred (OR=1.781, 95% Cl 1.238 to 2.562;p=0.002 ), number of oocytes retrieved ( $\mathrm{O}\mathrm{R}=\mathrm{1.071,95}\mathrm{\%}\mathrm{C}\mathrm{l}1.016$OR=1.071,95%Cl1.016 to 1.130;p=0.011 ), optimal embryo rate (OR=21.347, 95% CI 2.647 to 172.131; p=0.004 ) and level of antral follicles (OR $=\mathrm{1.444,95}\mathrm{\%}\mathrm{C}\mathrm{l}$=1.444,95%Cl 1.131 to 1.845;p=0.003 ) were independent predictors of clinical pregnancy after ET in PCOS infertile patients. The predictive model constructed based on these predictors had an area under the curve of 0.732 ( $95\mathrm{\%}\mathrm{C}\mathrm{l}$95%Cl : 0.683 to 0.782 ) for clinical pregnancy.

Conclusions Our study found that LH/FSH, FT4 level, number of embryos transferred, number of oocytes retrieved, optimal embryo rate and level of antral follicles were significantly associated with clinical pregnancy rate in PCOS infertility patients after assisted reproductive therapy. Combining these variables can effectively predict clinical pregnancy.

Acknowledgements Thank you to the entire team of the Reproductive Medicine Department for your support and assistance.

Contributors Y-HL, XB and Y-XY conceived the study and supervised the project and statistical processing and manuscript drafting. S-HW, X-JZ and T-TY contributed to data collection and analysis performed. All authors reviewed the manuscript, provided critical revisions and approved the final version. XB is the guarantor.

Funding This work was supported by Liaoning Provincial Science and Technology Program Joint Plan (Applied Basic Research Project) grant number 2023JH2/101700091.

Competing interests None declared.

Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

Patient consent for publication Not applicable.

Ethics approval This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of General Hospital of Northern Theater Command[Date: 2025.01.13/Research Ethics Review No. (2025) 002]. Participants gave informed consent to participate in the study before taking part.

Provenance and peer review Not commissioned; externally peer reviewed.

Data availability statement No data are available.

Open access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See https://creativecommons.org/licenses/by-nc/4.0/.

ORCID iD

Xue Bai https://orcid.org/0000-0002-8268-931X

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