What is the clinical evidence from this study?

Study design: RCT. Population: Polycystic ovary syndrome (PCOS) complicated by obstructive sleep apnea (OSA) and infertility (n=101). Intervention: Continuous positive airway pressure (CPAP) plus lifestyle intervention vs. Lifestyle intervention alone. Primary outcome: Clinical pregnancy rate (p=0.041).

What does this research mean for the field?

Continuous positive airway pressure (CPAP) therapy significantly increases the clinical pregnancy rate and improves metabolic abnormalities in infertile women with polycystic ovary syndrome (PCOS) complicated by obstructive sleep apnea (OSA). Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Investigate the effects of obstructive sleep apnea on clinical symptoms and pregnancy outcomes in women with polycystic ovary syndrome.

April 19, 2026Open Access

Clinical characteristics and pregnancy outcomes in polycystic ovary syndrome complicated by obstructive sleep apnea: a correlative study

Key Result

Continuous positive airway pressure therapy significantly increased the clinical pregnancy rate to 38.0% compared to 19.6% in the control group among infertile women with PCOS and OSA.

Key Points

Investigate the effects of obstructive sleep apnea on clinical symptoms and pregnancy outcomes in women with polycystic ovary syndrome.
Enrolled 294 infertile women with PCOS from Heze Municipal Hospital.
Collected clinical and metabolic data to analyze factors associated with OSA.
Women were randomized into control and CPAP treatment groups for intervention evaluation.
34.4% of women with PCOS were found to have OSA, with 10.9% having moderate to severe OSA.
Higher body mass index, hyperinsulinemia, elevated triglycerides, and lower AMH levels correlated with increased OSA risk.
The CPAP treatment group showed reduced testosterone, insulin, and triglyceride levels and a higher clinical pregnancy rate compared to controls.

Study Design

Type

RCT (n=101)

Blinding

Open-label

Randomization

1:1 ratio via computer-generated allocation sequence

Multicenter

Structured PICO

Does continuous positive airway pressure (CPAP) therapy improve reproductive endocrine function, glucose-lipid metabolism, and pregnancy outcomes in infertile women with polycystic ovary syndrome and obstructive sleep apnea?

Population

294 infertile women with polycystic ovary syndrome (PCOS), aged 19-40 years, including 101 with comorbid obstructive sleep apnea (OSA) who were randomized in the intervention trial. Mean age 27.61 years. Excluded: ovarian insufficiency, severe endocrine diseases, recent use of ovulation-inducing or lipid-lowering medications.

Intervention

Continuous positive airway pressure (CPAP) therapy combined with an 8-week lifestyle intervention (dietary and exercise guidance), followed by 3 consecutive cycles of assisted reproductive treatment (ovulation monitoring, timed intercourse, and artificial insemination).

Comparator

8-week lifestyle intervention alone (dietary and exercise guidance), followed by 3 consecutive cycles of assisted reproductive treatment.

Outcome

Changes in hormonal and metabolic parameters (testosterone, insulin, triglycerides) and clinical pregnancy rate.

In infertile women with polycystic ovary syndrome and obstructive sleep apnea, CPAP therapy combined with lifestyle intervention improves metabolic abnormalities and significantly increases clinical pregnancy rates.

Main Result

Absolute Event Rate: 38% vs 19.6%

p-value: p=0.041

Limitations

Absence of a healthy non-PCOS control group
Moderate sample size and small CPAP intervention cohort
Short-term 8-week intervention duration limits assessment of long-term effects
Adjustment for BMI could not fully eliminate obesity as a confounding factor
Combination of CPAP therapy with ovulation induction and assisted reproductive treatments may have confounded the observed effects on fertility

Abstract

Background Polycystic ovary syndrome (PCOS) is associated with a high prevalence of obstructive sleep apnea (OSA); however, its impact on the clinical manifestations of PCOS remains unclear. Objective This study aimed to investigate the clinical characteristics, reproductive endocrine profiles, and glucose–lipid metabolic features in women with PCOS complicated by OSA and to evaluate their potential implications for pregnancy outcomes. Methods A total of 294 infertile women with PCOS treated at Heze Municipal Hospital between February 2023 and December 2024 were enrolled after excluding ineligible participants. Clinical characteristics and reproductive endocrine and metabolic parameters were collected, and factors associated with OSA in women with PCOS were analyzed using the univariate analysis and the logistic regression analysis. Additionally, 101 women with PCOS and OSA were randomly assigned to either a lifestyle intervention control group or a lifestyle intervention and continuous positive airway pressure (CPAP) group, and changes in hormonal and metabolic parameters as well as pregnancy outcomes were evaluated. Results The prevalence of OSA in women with PCOS was 34.4%, of whom 10.9% had moderate to severe OSA. Higher body mass index, hyperinsulinemia, elevated triglycerides (TGs), and reduced anti-Müllerian hormone (AMH) levels were independently associated with an increased risk of OSA in women with PCOS. Compared with the control group, the CPAP treatment group exhibited significant reductions in serum testosterone (T), insulin (INS), and triglyceride (TG) levels, along with a significantly higher clinical pregnancy rate ( p 0.05). Conclusion Infertile women with PCOS and OSA exhibit significant disturbances in reproductive endocrine and glucose–lipid metabolism. CPAP therapy may improve these metabolic abnormalities, and when combined with ovulation induction and assisted reproduction, it may lead to better pregnancy outcomes, highlighting the potential benefit of early screening and intervention for OSA in women with PCOS.

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