Association between preconception serum lipid levels and treatment outcomes in women with polycystic ovary syndrome who underwent ovulation induction

Abstract

Research Question

To explore the association between preconception serum lipid levels and reproductive outcomes after ovulation induction in women with polycystic ovary syndrome (PCOS).

Design

This was a secondary analysis of a randomized controlled trial with 1000 PCOS women undergoing ovulation induction with clomiphene +/- acupuncture. Preconception serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) were measured. Outcomes were ovulation, conception, pregnancy, live birth, miscarriage. Logistic regression was used to calculate odds ratio (OR) with 95% confidence interval (CI).

Results

Totally, 780 women ovulated, 320 women achieved conception, 218 had pregnancy, 205 had live birth and 115 had miscarriage. Serum lipid levels per one unit increment were independently associated with reproductive outcomes after controlling confounders. Increasing LDL-C (OR: 0.79, 95%CI: 0.63-0.99) was independently associated with lower chance of ovulation. Increasing TC (OR: 0.76, 95%CI: 0.62-0.92), LDL-C (OR: 0.73, 95%CI: 0.57-0.93), TG (OR: 0.74, 95%CI: 0.58-0.95), ApoB (OR: 0.34, 95%CI: 0.16-0.74) were independently associated with lower chance of pregnancy. Increasing TC (OR: 0.78, 95%CI: 0.64-0.96), LDL-C (OR: 0.77, 95%CI: 0.60-0.99), TG (OR: 0.76, 95%CI: 0.59-0.96), ApoB (OR: 0.39, 95% CI:0.18-0.86) were independently associated with lower chance of live birth. Furthermore, increasing TC (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 higher chance of miscarriage.

Conclusions

Increased serum lipids were negatively associated with the reproductive outcomes of PCOS women undergoing ovulation induction with clomiphene +/- acupuncture.