Good obstetrical outcome is compromised in pregnancies resulting from single frozen-thawed euploid embryo transfers (fet) in women with pcos

To evaluate whether good obstetrical outcome differ between women with PCOS and those with other fertility diagnoses in pregnancies resulting from single frozen-thawed euploid embryo transfers (FET). Retrospective cohort analysis of SART CORS database 2016-2018. Autologous single FET cycles of PGT-A tested blastocysts were included. Primary outcome was good obstetrical outcomes (GOO), defined as a singleton live birth at ≥ 37 weeks of gestation with birth weight of 2500-3999 g. Secondary outcomes included positive ß-hCG, clinical intrauterine pregnancy (CP) and preterm birth (PTB). Exclusion criteria were recurrent pregnancy loss and gestational carrier. A generalized estimating equation approach was utilized to account for correlated data due to repeated cycles within a subject. Based on evidence of interaction between PCOS and BMI for GOO and PTB outcomes, multivariate analyses were stratified by BMI. Data are presented as odds ratios (OR) with 95% confidence intervals (CI). 79,416 FET cycles met eligibility criteria, 15% were in women with PCOS. After adjusting for age, race/ethnicity, smoking, endometrial thickness, uterine factor and AMH, the diagnosis of PCOS was significantly associated with reduced likelihood of GOO and increased risk of PTB, but only in the obese population (Table). Pregnancies among obese women with PCOS had 18% lower likelihood of GOO and a 39% increased likelihood of PTB compared to pregnancies in obese women with other fertility diagnoses. Non-obese women with PCOS had similar frequencies of GOO and PTB to the reference population. While the outcome of positive ß-HCG was unrelated to the PCOS diagnosis, the likelihood of CP was decreased among women with PCOS. Singleton pregnancies in obese women with PCOS are less likely to result in a full term birth of a normal weight infant.