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
- 1Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052 China
- 2Henan Institute of Medical & Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450052 China
Abstract
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.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09718-6.
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BibTeX
@article{bu2026genetic,
title = {{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}},
author = {Zhiqin Bu and Xiaofei Ge and Jing Sun and Keyan Wang},
journal = {BMC Pregnancy and Childbirth},
year = {2026},
month = jul,
doi = {10.1186/s12884-026-09718-6},
url = {https://doi.org/10.1186/s12884-026-09718-6},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - 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
AU - Zhiqin Bu
AU - Xiaofei Ge
AU - Jing Sun
AU - Keyan Wang
PY - 2026
DA - 2026/07/31
JO - BMC Pregnancy and Childbirth
DO - 10.1186/s12884-026-09718-6
UR - https://doi.org/10.1186/s12884-026-09718-6
AB - 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. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12884-026-09718-6.
SN - 1471-2393
ER -