Genetic,lifestyle,and environmental factors contribute to the etiology of polycystic ovary syndrome(PCOS).Increased body mass index(BMI)exacerbates the reproductive and metabolic parameters and reduces the fecundity o...Genetic,lifestyle,and environmental factors contribute to the etiology of polycystic ovary syndrome(PCOS).Increased body mass index(BMI)exacerbates the reproductive and metabolic parameters and reduces the fecundity of women with PCOS.This is a secondary analysis of a large-sample,multicenter,randomized controlled trial conducted at 21 sites in Chinese mainland.A total of 1000 women diagnosed with PCOS were enrolled in this trial.Of these,998 women with PCOS were included in the analysis.Increased BMI was associated with more severe menstrual irregularities,elevated testosterone level,higher prevalence of metabolic syndrome,and poorer quality of life.The rates of ovulation per woman for the normal,overweight,and obese BMI groups were 83.0%,78.2%,and 63.6%,respectively(P<0.001),and the rates of live birth were 23.6%,18.1%,and 15.3%(P=0.030).Northern PCOS patients showed more severe reproductive,glucose,and lipid profiles;less exercise;and lower total ovulation rates compared with PCOS patients from Southern China(74.8%vs 81.2%,absolute difference 6.4%,95%confidence interval 1.2%–11.5%).The results show the typical phenotypic features of Han women with PCOS in Northern and Southern China.The women living in Northern China showed a higher BMI,more severe glycolipid metabolism profiles,and subsequently worse clinical outcomes by the same interventions than those living in Southern China.The difference in phenotypic features can be explained mostly by differences in BMI and the resulting difference in ovulation.展开更多
In this study,normal values of semen analysis were set for a general infertile population of couples among which most women had normal ovulation.The predictive capacity values of sperm quality,including concentration,...In this study,normal values of semen analysis were set for a general infertile population of couples among which most women had normal ovulation.The predictive capacity values of sperm quality,including concentration,motile count,progressive motile count,and morphology,are unclear for women with polycystic ovary syndrome(PCOS).A secondary analysis was conducted based on a randomized controlled trial investigating infertility among women with PCOS experiencing ovulatory disorder between 2011 and 2016 in China.A total of 1000 women received ovulation induction(acupuncture and clomiphene).We randomized the women with PCOS in 27 hospitals in China who received one of four interventions(acupuncture plus clomiphene,sham acupuncture plus clomiphene,acupuncture plus placebo,or sham acupuncture plus placebo).Semen analysis was performed for every male partner according to the World Health Organization(WHO)criteria.The outcomes included conception,clinical pregnancy,and live birth.Logistic regression was used to evaluate the predictive value of semen analysis among ovulatory women for conception,clinical pregnancy,and live birth.Among the 1000 couples,the number of couples who attained ovulation,conception,clinical pregnancy,and live birth were 780,320,235,and 205,respectively.Semen volume and motility were applied and used as prediction parameters for conception(area under the curve(AUC)of 0.62(95%confidence interval(CI),0.55–0.69)),clinical pregnancy(AUC of 0.67(95%CI:0.61–0.73)),and live birth(AUC of 0.57(95%CI:0.50–0.64)).No poor calibration was shown for these models in Hosmer–Lemeshow tests.The predictive capacity of semen analysis for treatment outcome in PCOS women with PCOS experiencing with ovulatory dysfunction is limited.展开更多
基金supported by the National key Research and Development Program of China (2019YFC1709500)the National Collaboration Project of Critical Illness by Integrating Chinese Medicine and Western Medicine+8 种基金the Project of Heilongjiang Province Innovation Team “Tou Yan”the Yi-Xun Liu and Xiao-Ke Wu Academician Workstationthe Innovation Team of Reproductive Technique with Integrative Chinese Medicine and Western Medicine in Xuzhou City, ChinaHeilongjiang University of Chinese Medicine from the National Clinical Trial BaseHeilongjiang Provincial Clinical Research Center for Ovary Diseasesthe Research Grant Council (T13-602/21-N, C5045-20EF, and 14122021)Food and Health Bureau in Hong Kong, China (06171026)supported by a National Health and Medical Research Council (NHMRC) Investigator grant (GNT1176437)travel support from Merck.
基金This study was supported by National Public Welfare Projects for Chinese Medicine(201507001-02)the Heilongjiang Province General Institutes of Higher Education Youth Innovative Talents Program(UNPYSCT-2017226)the Scientific Research Project of Outstanding Innovative Talents Program of Heilongjiang University of Chinese Medicine(2018RC012),Xuzhou Clinical Medical Team Talent Introduction Project—Academician Liu Yixun Integrated Chinese and Western medicine,Maternity and Reproductive Technology Innovation Team,and Academician Liu Yixun Workstation Project.
文摘Genetic,lifestyle,and environmental factors contribute to the etiology of polycystic ovary syndrome(PCOS).Increased body mass index(BMI)exacerbates the reproductive and metabolic parameters and reduces the fecundity of women with PCOS.This is a secondary analysis of a large-sample,multicenter,randomized controlled trial conducted at 21 sites in Chinese mainland.A total of 1000 women diagnosed with PCOS were enrolled in this trial.Of these,998 women with PCOS were included in the analysis.Increased BMI was associated with more severe menstrual irregularities,elevated testosterone level,higher prevalence of metabolic syndrome,and poorer quality of life.The rates of ovulation per woman for the normal,overweight,and obese BMI groups were 83.0%,78.2%,and 63.6%,respectively(P<0.001),and the rates of live birth were 23.6%,18.1%,and 15.3%(P=0.030).Northern PCOS patients showed more severe reproductive,glucose,and lipid profiles;less exercise;and lower total ovulation rates compared with PCOS patients from Southern China(74.8%vs 81.2%,absolute difference 6.4%,95%confidence interval 1.2%–11.5%).The results show the typical phenotypic features of Han women with PCOS in Northern and Southern China.The women living in Northern China showed a higher BMI,more severe glycolipid metabolism profiles,and subsequently worse clinical outcomes by the same interventions than those living in Southern China.The difference in phenotypic features can be explained mostly by differences in BMI and the resulting difference in ovulation.
基金This study was supported by the National Public Welfare Projects for Chinese Medicine(201107005)the National Key Research and Development Program of China(2019YFC1709500)+2 种基金the Project of Heilongjiang University of Chinese Medicine(2018RCQ12 and 2019BS09)the Projects of Heilongjiang Provincial Administration of Traditional Chinese medicine(ZHY2020-102)Xuzhou Clinical Medical Team Talent Introduction Project--Academician Yixun Liu Integrated Chinese and Western medicine,Maternity and Reproductive Technology Innovation Team,and Academician Yixun Liu Workstation Project.
文摘In this study,normal values of semen analysis were set for a general infertile population of couples among which most women had normal ovulation.The predictive capacity values of sperm quality,including concentration,motile count,progressive motile count,and morphology,are unclear for women with polycystic ovary syndrome(PCOS).A secondary analysis was conducted based on a randomized controlled trial investigating infertility among women with PCOS experiencing ovulatory disorder between 2011 and 2016 in China.A total of 1000 women received ovulation induction(acupuncture and clomiphene).We randomized the women with PCOS in 27 hospitals in China who received one of four interventions(acupuncture plus clomiphene,sham acupuncture plus clomiphene,acupuncture plus placebo,or sham acupuncture plus placebo).Semen analysis was performed for every male partner according to the World Health Organization(WHO)criteria.The outcomes included conception,clinical pregnancy,and live birth.Logistic regression was used to evaluate the predictive value of semen analysis among ovulatory women for conception,clinical pregnancy,and live birth.Among the 1000 couples,the number of couples who attained ovulation,conception,clinical pregnancy,and live birth were 780,320,235,and 205,respectively.Semen volume and motility were applied and used as prediction parameters for conception(area under the curve(AUC)of 0.62(95%confidence interval(CI),0.55–0.69)),clinical pregnancy(AUC of 0.67(95%CI:0.61–0.73)),and live birth(AUC of 0.57(95%CI:0.50–0.64)).No poor calibration was shown for these models in Hosmer–Lemeshow tests.The predictive capacity of semen analysis for treatment outcome in PCOS women with PCOS experiencing with ovulatory dysfunction is limited.
