Objective To investigate the impact of multiple pronuclei(PN) on the outcome of frozen-thawed embryo transfer(FET) in infertile women with polycystic ovary syndrome(PCOS). Methods A total of 2 665 patients who underwent IVF treatment in Women's Hospital of Nanjing Medical University from January 2016 to December 2021 were retrospectively analyzed. First, they were divided into PCOS group(N=1295) and control group(N=1370) according to the cause of infertility, and the incidence of multiple PN was compared between the two groups. Subsequently, we only included patients whose whole embryos were frozen and underwent FET in the PCOS group, and excluded those who were lost to follow-up or who had not yet arrived for delivery. Finally, 999 PCOS patients were included and divided into three subgroups according to fertilization status:547 patients in the 2PN group, 414 cases in the low-proportion multiple PN group(multiple PN rate ≤20%), and 38 cases in the high-proportion multiple PN group(multiple PN rate >20%). The clinical outcomes of these three subgroups were compared. Results The PCOS group had a significantly higher rate of multiple PN than the control group(P<0.05). Compared with patients in the 2PN group, those in the the low proportion of multi-PN group had higher baseline AMH, number of oocytes retrieved and number of IVF oocytes(P<0.05), lower number of transferable embryos, blastocyst formation rate and high-quality blastocysts, biochemical pregnancy rate and live birth rate were lower(P<0.05). The number of retrieved oocytes and IVF oocytes in high proportion of multi-PN group were lower than those in low proportion of multi-PN group(P<0.05), the number of transferable embryos, blastocyst formation rate, and high-quality blastocysts in low proportion of multi-PN group were lower than those in 2PN group and low proportion of multi-PN group(P<0.05), and the biochemical pregnancy rate and live birth rate were lower than those in 2PN group and low proportion of multi-PN group(P<0.05). There was no significant difference in embryo implantation rate and clinical pregnancy rate among the three groups(P>0.05). Conclusion Multiple PN in PCOS patients undergoing FET reduces embryo quality, biochemical pregnancy rate and live birth rate.
Key words
polycystic ovarian syndrome /
multiple pronuclei /
frozen-thawed embryo transfer /
pregnancy Outcomes
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