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Purpose <p>To provide an updated and comprehensive assessment of euploid embryo rates in polycystic ovarian syndrome (PCOS) women compared with non-PCOS counterparts undergoing preimplantation genetic testing for aneuploidy (PGT-A), and to evaluate early spontaneous miscarriage (ESM) rates across different PCOS phenotypes following single vitrified euploid blastocyst transfer cycles.</p> Methods <p>This retrospective cohort study (2017–2023) included women with PCOS and non-PCOS controls. Two cohorts were analyzed: first PGT-A cycles and first single vitrified euploid blastocyst transfers. ESM and euploidy rates were assessed, and regression analyses were performed to identify factors associated with miscarriage.</p> Results <p>In the PCOS group, a total of 1,274 blastocysts were biopsied, of which 580 were euploid, yielding a euploidy rate of 45.53% (580/1,274), which was significantly higher than the 39.86% (1,935/4,854) observed in non-PCOS women (<i>P</i> &lt; 0.001). Additionally, 345 PCOS and 1,650 non-PCOS frozen-thawed embryo transfer cycles involving the first single vitrified euploid blastocyst were included in the analysis. ESM rates were 14.48% (21/145) in the polycystic ovarian morphology (PCOM)+ ovulation disorder (OD) subgroup, 18.75% (6/32) in the PCOM+ Hyperandrogenism (HA) subgroup, and 31.70% (13/41) in the PCOM + OD+HA subgroup. After adjusting for covariates, the PCOM + OD+HA phenotype remained an independent risk factor for ESM (adjusted OR: 2.164; 95% CI: 1.209–6.247; <i>P</i> = 0.036).</p> Conclusion <p>The high ESM rate observed in PCOS patients may be attributable to their endocrine abnormalities. These findings suggest that non-genetic, environmental factors—rather than genetic factors—warrant greater attention in future strategies aimed at reducing ESM in this population.</p>

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Genetic and non-genetic contributions to early spontaneous miscarriage in women with PCOS undergoing PGT-A and single euploid blastocyst transfer: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月31日

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  • Zhiqin Bu,
  • Xiaofei Ge,
  • Jing Sun,
  • Keyan Wang

摘要

Purpose

To provide an updated and comprehensive assessment of euploid embryo rates in polycystic ovarian syndrome (PCOS) women compared with non-PCOS counterparts undergoing preimplantation genetic testing for aneuploidy (PGT-A), and to evaluate early spontaneous miscarriage (ESM) rates across different PCOS phenotypes following single vitrified euploid blastocyst transfer cycles.

Methods

This retrospective cohort study (2017–2023) included women with PCOS and non-PCOS controls. Two cohorts were analyzed: first PGT-A cycles and first single vitrified euploid blastocyst transfers. ESM and euploidy rates were assessed, and regression analyses were performed to identify factors associated with miscarriage.

Results

In the PCOS group, a total of 1,274 blastocysts were biopsied, of which 580 were euploid, yielding a euploidy rate of 45.53% (580/1,274), which was significantly higher than the 39.86% (1,935/4,854) observed in non-PCOS women (P < 0.001). Additionally, 345 PCOS and 1,650 non-PCOS frozen-thawed embryo transfer cycles involving the first single vitrified euploid blastocyst were included in the analysis. ESM rates were 14.48% (21/145) in the polycystic ovarian morphology (PCOM)+ ovulation disorder (OD) subgroup, 18.75% (6/32) in the PCOM+ Hyperandrogenism (HA) subgroup, and 31.70% (13/41) in the PCOM + OD+HA subgroup. After adjusting for covariates, the PCOM + OD+HA phenotype remained an independent risk factor for ESM (adjusted OR: 2.164; 95% CI: 1.209–6.247; P = 0.036).

Conclusion

The high ESM rate observed in PCOS patients may be attributable to their endocrine abnormalities. These findings suggest that non-genetic, environmental factors—rather than genetic factors—warrant greater attention in future strategies aimed at reducing ESM in this population.