Association between preconception serum lipid concentrations and treatment outcomes in women with PCOS who underwent ovulation induction. Issue 4 (October 2022)

• Record Type: Journal Article
• Authors: Cai, Wang-Yu; Luo, Xi; Ma, Hong-Li; Shao, Xiao-Guang; Wu, Xiao-Ke
• Is Part Of: Reproductive biomedicine online. Volume 45:Issue 4(2022)
• Page Start: 805
• Page End: 814
• Publication Date: 2022-10
• Subjects: Dyslipidemia -- Lipid -- Ovulation induction -- PCOS -- Reproductive outcomes; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2022.04.013
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: What is the association between preconception serum lipid concentrations and reproductive outcomes after ovulation induction in women with polycystic ovary syndrome (PCOS)? Design: A secondary analysis of a randomized controlled trial with 1000 PCOS women undergoing ovulation induction with clomiphene with or without acupuncture. Preconception serum total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) were measured. Outcomes were ovulation, conception, pregnancy, live birth and miscarriage. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: In total, 780 women ovulated; 320 women achieved conception, 218 had a clinical pregnancy, 205 had a live birth and 115 had a miscarriage. Serum lipid concentrations per one unit increment were independently associated with reproductive outcomes after controlling for confounders. Increasing LDL-C (OR 0.79, 95% CI 0.63–0.99) was independently associated with a lower chance of ovulation. Increasing total cholesterol (OR 0.76, 95% CI 0.62–0.92), LDL-C (OR 0.73, 95% CI 0.57–0.93), triglycerides (OR 0.74, 95% CI 0.58–0.95) and ApoB (OR 0.34, 95% CI 0.16–0.74) were independently associated with a lower chance of clinical pregnancy. Increased total cholesterol (OR 0.78, 95% CI 0.64–0.96), LDL-C (OR 0.77, 95% CI 0.60–0.99), triglycerides (OR 0.76, 95% CI 0.59–0.96) and ApoB (OR 0.39, 95% CI 0.18–0.86) were independently associated with a lower chance of live birth. Furthermore, increased total cholesterol (OR 1.43, 95% CI 1.06–1.93), LDL-C (OR 1.51, 95% CI 1.04–2.19) and ApoB (OR 3.82, 95% CI 1.17–12.41) were independently associated with a higher chance of miscarriage. Conclusions: Increased serum lipids were negatively associated with the reproductive outcomes of PCOS women undergoing ovulation induction with clomiphene with or without acupuncture.