Amelia Purser Bailey
Brigham and Women’s Hospital, USA
Title: Clinical and embryologic in vitro fertilization (IVF) outcomes in polycystic ovary syndrome (PCOS) based on body mass index
Biography
Biography: Amelia Purser Bailey
Abstract
Considering that 50% of PCOS patients are not obese, characterizing associations of a range of BMI with IVF outcomes could inform management of PCOS patients. Specifically, characterizing relationships between BMI and ovarian hyper-stimulation syndrome (OHSS) would lay the groundwork for investigation of BMI-dependent dosing of gonadotropins to reduce morbidity due to OHSS, a serious disease for which PCOS patients are at elevated risk. This retrospective cohort study included 101 IVF cycles from 79 women <40 years old with a clinically-documented diagnosis of PCOS. Participants were stratified by BMI calculated within three months of cycle start: Lean (18.7-24.9 kg/m2, n=51), overweight (25-29.9 kg/m2, n=19), and obese (≥30 kg/m2, n=31). Linear, logistic, and Poisson regression were used to estimate the effect of a range of BMI on IVF outcomes while adjusting for potential confounders. Obese PCOS women had 69% lower odds of clinical pregnancy per cycle start [odds ratio (OR) =0.31, 95% confidence interval (CI) =0.11-0.86, p=0.02] and 77% lower odds of clinical pregnancy per embryo transfer (OR=0.23, 95% CI=0.08-0.68, p=0.008) compared to lean PCOS women. Among obese PCOS women, the odds of live birth were 71% lower per cycle start (OR=0.29, 95% CI=0.10-0.84, p=0.02) and 77% lower per embryo transfer (OR=0.23, 95% CI=0.07-0.71, p=0.01) compared to lean PCOS women. There was a trend toward decreased OHSS incidence with increasing BMI among women with PCOS: 19.6% in lean, 10.5% in overweight and 3.2% in obese. In conclusion, PCOS is a broad syndrome with our results demonstrating two distinct populations, lean and obese, which have different IVF outcomes including OHSS risk profiles.