![]() FET has been widely used for PCOS patients to minimize the risk of OHSS. The altered hormone level may adversely affect endometrial receptivity in fresh embryo transfer. Women with PCOS tend to have more oocytes retrieved and an elevated estradiol level. ![]() Patients with PCOS have hyper-responsiveness to gonadotropin stimulation. As national consensus continues to endorse single embryo transfer, more supernumerary embryos are available for cryopreservation. Studies have demonstrated comparable outcomes between fresh and frozen-thawed embryo transfer (FET). In recent years, the freeze-all policy of cryopreserving all embryos produced in an IVF cycle to transfer later has become more appropriate when there is a risk of ovarian hyperstimulation syndrome (OHSS), high progesterone level, preimplantation genetic testing (PGT), abnormal endometrium, and other conditions. This syndrome results in luteinizing hormone (LH) and follicle-stimulating hormone (FSH) ratio imbalance, cardiovascular diseases, obesity, infertility, and other health issues. It is characterized by a combination of the following three criteria: oligoovulation or anovulation, polycystic ovaries, and hyperandrogenism. Polycystic ovary syndrome (PCOS) is a common endocrine syndrome and affects between 8 and 18% of women. GnRHa pretreatment could not improve the live birth rate in women with PCOS. Similar results were obtained after propensity score matching in the entire cohort. In addition, there is a marginally difference after adjusting for covariates (aOR 1.56, 95%CI, 1.001–2.41, p = 0.048), this finding with p-value close to 0.05 represent insufficient empirical evidence. The preterm birth rate in GnRHa + HRT was higher than HRT (20.23% vs 13.04%). The clinical pregnancy rate (75.29% vs 70.62%), miscarriage rate (14.20% vs 13.81%) and ectopic pregnancy rate (0.39% vs 0.19%) were similar between the two groups. The live birth rate was higher in the GnRHa + HRT group compared with the HRT group with no significant difference (60.12% vs 56.03%, p = 0.073). Patients using GnRHa + HRT ( n = 514) were matched with 514 patients using HRT. In this retrospective cohort study, we used propensity score matching (PSM) to compare the live birth rate between patients who underwent FET with hormone replacement treatment (HRT) and patients with GnRHa pretreatment (GnRHa + HRT). Our objective was to compare the clinical outcomes of frozen-thawed embryo transfer (FET) with and without pretreatment gonadotropin-releasing hormone agonist (GnRHa) in PCOS patients. The ideal protocols of endometrial preparation for polycystic ovary syndrome (PCOS) patients are lacking and need further declaration. ![]()
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