An early LH surge may jeopardize ART outcomes of patients with PCOS and its predictive models

This study aimed to investigate whether an early LH surge during controlled ovarian stimulation (COS) affects pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) undergoing assisted reproductive technology (ART) and to explore methods for identifying high-risk patients for early intervention. In a retrospective case-control analysis of 786 PCOS cycles, an early LH surge was found to significantly increase the spontaneous abortion rate and reduce the live birth rate in in vitro fertilization and multiple embryo transfer cycles, while also correlating with a higher preterm birth rate in frozen embryo transfer cycles. Using the training set of 786 cycles, three predictive models for LH surge were developed and validated in an independent time validation set of 76 cycles. Among them, model 2 demonstrated optimal performance, with prediction feasible as early as COS day 0 and an AUC of 0.713. The findings indicate that an early LH surge may compromise ART outcomes in specific PCOS subgroups, and the proposed predictive models could aid clinicians in identifying high-risk patients and adapting treatment strategies accordingly.

For women with polycystic ovary syndrome (PCOS) undergoing fertility treatment, a premature hormone surge can sometimes disrupt the process. Our study investigated how this early 'luteinizing hormone (LH) surge' affects pregnancy success. We found that women who experienced this early surge had more eggs collected. However, for those who had a fresh embryo transfer, it led to a higher risk of miscarriage and a lower chance of having a baby. If they used frozen embryos in a later cycle, the risk of premature birth was higher. To help patients, we also created a prediction tool. This tool uses simple information collected at the start of treatment - like a woman's body mass index and hormone levels - to identify those at high risk of this early surge. By spotting these patients early, doctors can personalize their treatment to improve their chances of a successful and healthy pregnancy.