Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance
BACKGROUND: Recent studies have reported higher risks of adverse maternal and neonatal outcomes, such as hypertensive disorders of pregnancy, after programmed frozen embryo transfer, especially in cycles with gonadotropin-releasing hormone agonist pretreatment. It remains unclear if GnRH agonist pre...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | AJOG Global Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666577823000424 |
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| author | Hui-ying Jie, MD Ruifang Hu, BS Limei Zhang, MD Kexin Dong, MD Chunyan Wu, MD Qiong Wang, MD Lu Luo, MD |
| author_facet | Hui-ying Jie, MD Ruifang Hu, BS Limei Zhang, MD Kexin Dong, MD Chunyan Wu, MD Qiong Wang, MD Lu Luo, MD |
| author_sort | Hui-ying Jie, MD |
| collection | DOAJ |
| description | BACKGROUND: Recent studies have reported higher risks of adverse maternal and neonatal outcomes, such as hypertensive disorders of pregnancy, after programmed frozen embryo transfer, especially in cycles with gonadotropin-releasing hormone agonist pretreatment. It remains unclear if GnRH agonist pretreatment before programmed frozen embryo transfer further increases the risk for obstetrical complications among women with polycystic ovary syndrome. OBJECTIVE: This study aimed to compare the obstetrical and neonatal complications of singleton and twin pregnancies after programmed frozen embryo transfer with or without gonadotropin-releasing hormone-a pretreatment among women with polycystic ovary syndrome. STUDY DESIGN: This was a secondary analysis of a single-center, randomized controlled trial comparing the live birth rate and cost-effectiveness of programmed cycle-prepared frozen embryo transfers with or without gonadotropin-releasing hormone agonist pretreatment among women with polycystic ovary syndrome. The analysis was restricted to women with polycystic ovary syndrome, aged 24 to 40 years, who delivered live neonates after frozen-thawed blastocyst transfer. The obstetrical and neonatal outcomes were compared between programmed cycles with and those without gonadotropin-releasing hormone agonist pretreatment. The adjusted odds ratios with 95% confidence intervals were calculated and adjustments were made for relevant confounders. RESULTS: The maternal and neonatal complications associated with 177 live single births and 38 twin births (253 newborns in total) were analyzed. There were no significant differences in the frequencies of obstetrical complications, including hypertensive disorders of pregnancy, between the gonadotropin-releasing hormone agonist pretreatment and no pretreatment group for both singleton and twin pregnancies. However, there was a significantly greater incidence of having a low birthweight neonate among singleton infants born after gonadotropin-releasing hormone agonist pretreatment when compared with no pretreatment (10.2% vs 1.3%; P=0.042), and a low birthweight among singleton infants was still more likely after adjusting for confounders (relative ratio, 3.85; 95% confidence interval, 1.13−7.11; P=.024). Other neonatal complications were all comparable between the pretreatment and no pretreatment groups for both singleton and twin pregnancies. CONCLUSION: For women with polycystic ovary syndrome, programmed frozen embryo transfer cycles with gonadotropin-releasing hormone agonist pretreatment could lead to a greater risk of having a low birthweight singleton neonate. |
| first_indexed | 2024-03-13T05:57:56Z |
| format | Article |
| id | doaj.art-67d2c92b814540648b7ec9074233b908 |
| institution | Directory Open Access Journal |
| issn | 2666-5778 |
| language | English |
| last_indexed | 2024-03-13T05:57:56Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
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| series | AJOG Global Reports |
| spelling | doaj.art-67d2c92b814540648b7ec9074233b9082023-06-13T04:12:51ZengElsevierAJOG Global Reports2666-57782023-05-0132100201Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a GlanceHui-ying Jie, MD0Ruifang Hu, BS1Limei Zhang, MD2Kexin Dong, MD3Chunyan Wu, MD4Qiong Wang, MD5Lu Luo, MD6Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo); Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China (Dr Jie, Ms Hu, Dr Zhang, Dr Dong, Dr Wu, and Drs Wang and Luo).; Corresponding author: Lu Luo, MD.BACKGROUND: Recent studies have reported higher risks of adverse maternal and neonatal outcomes, such as hypertensive disorders of pregnancy, after programmed frozen embryo transfer, especially in cycles with gonadotropin-releasing hormone agonist pretreatment. It remains unclear if GnRH agonist pretreatment before programmed frozen embryo transfer further increases the risk for obstetrical complications among women with polycystic ovary syndrome. OBJECTIVE: This study aimed to compare the obstetrical and neonatal complications of singleton and twin pregnancies after programmed frozen embryo transfer with or without gonadotropin-releasing hormone-a pretreatment among women with polycystic ovary syndrome. STUDY DESIGN: This was a secondary analysis of a single-center, randomized controlled trial comparing the live birth rate and cost-effectiveness of programmed cycle-prepared frozen embryo transfers with or without gonadotropin-releasing hormone agonist pretreatment among women with polycystic ovary syndrome. The analysis was restricted to women with polycystic ovary syndrome, aged 24 to 40 years, who delivered live neonates after frozen-thawed blastocyst transfer. The obstetrical and neonatal outcomes were compared between programmed cycles with and those without gonadotropin-releasing hormone agonist pretreatment. The adjusted odds ratios with 95% confidence intervals were calculated and adjustments were made for relevant confounders. RESULTS: The maternal and neonatal complications associated with 177 live single births and 38 twin births (253 newborns in total) were analyzed. There were no significant differences in the frequencies of obstetrical complications, including hypertensive disorders of pregnancy, between the gonadotropin-releasing hormone agonist pretreatment and no pretreatment group for both singleton and twin pregnancies. However, there was a significantly greater incidence of having a low birthweight neonate among singleton infants born after gonadotropin-releasing hormone agonist pretreatment when compared with no pretreatment (10.2% vs 1.3%; P=0.042), and a low birthweight among singleton infants was still more likely after adjusting for confounders (relative ratio, 3.85; 95% confidence interval, 1.13−7.11; P=.024). Other neonatal complications were all comparable between the pretreatment and no pretreatment groups for both singleton and twin pregnancies. CONCLUSION: For women with polycystic ovary syndrome, programmed frozen embryo transfer cycles with gonadotropin-releasing hormone agonist pretreatment could lead to a greater risk of having a low birthweight singleton neonate.http://www.sciencedirect.com/science/article/pii/S2666577823000424endometrium preparationfrozen-thawed embryo transfergonadotropin-releasing hormone agonisthormone replacement therapypolycystic ovary syndrome |
| spellingShingle | Hui-ying Jie, MD Ruifang Hu, BS Limei Zhang, MD Kexin Dong, MD Chunyan Wu, MD Qiong Wang, MD Lu Luo, MD Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance AJOG Global Reports endometrium preparation frozen-thawed embryo transfer gonadotropin-releasing hormone agonist hormone replacement therapy polycystic ovary syndrome |
| title | Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance |
| title_full | Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance |
| title_fullStr | Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance |
| title_full_unstemmed | Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance |
| title_short | Obstetric and neonatal outcomes after programmed frozen embryo transfer with or without GnRH agonist for polycystic ovary syndrome: secondary analysis results from a randomized controlled trialAJOG Global Reports at a Glance |
| title_sort | obstetric and neonatal outcomes after programmed frozen embryo transfer with or without gnrh agonist for polycystic ovary syndrome secondary analysis results from a randomized controlled trialajog global reports at a glance |
| topic | endometrium preparation frozen-thawed embryo transfer gonadotropin-releasing hormone agonist hormone replacement therapy polycystic ovary syndrome |
| url | http://www.sciencedirect.com/science/article/pii/S2666577823000424 |
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