Effect of body mass index on pregnancy outcomes with the freeze-all strategy in women with polycystic ovarian syndrome

Objective: To investigate the effects of body mass index (BMI) on assisted reproductive outcomes with the freeze-all strategy for patients with polycystic ovary syndrome (PCOS). Design: Retrospective cohort study. Setting: Tertiary care academic medical center. Patient(s): A total of 3,079 women with PCOS across different BMIs at our institution from January 2015 to May 2017 were stratified into cohorts. Intervention(s): None. Main Outcome Measure(s): Implantation rate, clinical pregnancy rate, early miscarriage rate, and live birth rate. Result(s): The live birth rate was most favorable in underweight (BMI < 18.5 kg/m(2)) and normal weight cohorts (18.5 <= BMI < 25 kg/m(2)) and progressively decreased as BMI increased. Moreover, the obese cohort (BMI >= 30 kg/m(2)) of patients with PCOS who had frozen ET cycles had a relatively high early miscarriage rate. Conclusion(s): The live birth rates are highest in underweight and normal weight patients with PCOS undergoing IVF with the freeze-all strategy. Furthermore, there is a progressive and statistically significant decrease in the live birth rate and an increase in the miscarriage rate in obese patients with PCOS. ((C) 2019 by American Society for Reproductive Medicine.)