A cohort study on the association between metabolic/inflammatory status and pregnancy complications in PCOS patients after IVF/ICSI treatment

This study aims to explore the impact of insulin resistance and metabolic abnormalities on metabolic changes, inflammatory responses, and pregnancy complications during in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatment in women with polycystic ovary syndrome (PCOS). A total of 100 PCOS patients who attended our hospital between February 2022 and February 2024, along with 100 control subjects with natural pregnancies, were included. Blood samples were analyzed for a range of parameters, including sex hormones (luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone, testosterone, and prolactin), glycometabolism (fasting plasma glucose, fasting insulin, and homeostasis model assessment of insulin resistance), liver and kidney function (triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, creatinine, blood urea nitrogen, and uric acid), and inflammatory markers (C-reactive protein, interleukins [IL-2, IL-4, IL-6, IL-8, IL-12, and IL-18]). Changes in metabolic and inflammatory indicators were monitored throughout different pregnancy stages (early, mid, and late), and pregnancy outcomes, neonatal birth weight, and Apgar scores were recorded. The PCOS-IVF/ICSI group exhibited significantly higher levels of body mass index, systolic blood pressure, menstrual cycle irregularities, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and hormones (luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone, and testosterone) compared to the natural pregnancy group (P < .05). Pregnancy metabolic analysis showed significantly elevated fasting plasma glucose, fasting insulin, and homeostasis model assessment of insulin resistance indices across all pregnancy stages in the PCOS group (P < .01). Inflammatory markers, including C-reactive protein, IL-2, IL-4, IL-6, IL-8, IL-12, and IL-18, were also significantly higher in the PCOS-IVF/ICSI group (P < .05). Pregnancy outcome analysis revealed that the PCOS-IVF/ICSI group had higher rates of miscarriage and pregnancy complications (P < .05), with no significant difference in preterm birth rates (P = .12). Neonatal birth weight and Apgar scores were slightly lower in the PCOS-IVF/ICSI group compared to the natural pregnancy group (P < .05). Compared to women with natural pregnancies, the PCOS-IVF/ICSI group showed increased risks of metabolic disorders, inflammatory responses, and pregnancy complications, with slightly poorer neonatal outcomes, suggesting a higher risk during pregnancy for PCOS patients.