Comparison of Endocrine Profile andIn VitroFertilization Outcome in Patients with PCOS, Ovulatory PCO, or Normal Ovaries

Abstract

Aim. To compare the basic endocrine profile and outcomes of in vitro fertilization (IVF) in women with polycystic ovary syndrome (PCOS), ovulatory polycystic ovaries (PCO), or normal ovaries (NO). Methods. The basic clinical features and in vitro fertilization and embryo transfer outcome in patients receiving IVF or intracytoplasmic sperm injection (ICSI) were retrospectively analyzed. Results. The body mass index, basal luteinizing hormone, and testosterone levels were significantly lower in patients with ovulatory PCO compared to those in patients with PCOS. The PCOS patients exhibited the shortest duration of ovarian stimulation and lowest dose of gonadotropin, followed by the ovulatory PCO and NO patients. The ovulatory PCO and PCOS patients showed similar levels of E2 on the human chorionic gonadotropin treatment day and numbers of oocytes, which were both significantly higher than those of the NO patients. The fertilization rate of the PCOS patients was significantly lower than the other two groups. Compared to NO patients, the cleavage rate was lower in both PCOS and ovulatory PCO patients, however, the number of available embryos was significantly more in these two groups. The incidence of the moderate to severe ovarian hyperstimulation syndrome (OHSS) was markedly higher in the PCOS and ovulatory PCO patients. Conclusion. Ovulatory PCO patients do not express similar endocrine abnormalities as PCOS patients. Although the fertilization rate and cleavage rate were relatively low in PCOS patients, ultimately, all the three groups showed similar transferred embryo numbers, clinical pregnancy rates, and implantation rates. Since the incidence of OHSS was much higher in the PCOS and ovulatory PCO patients, we should take more care of these patients and try to prevent severe OHSS.

Follicular hyperandrogenism downregulates aromatase in luteinized granulosa cells in polycystic ovary syndrome women

“…These results suggest for the first time that the down-regulation of aromatase in PCOS may be a result of the hyperandrogenic follicular environment. Consistent with previous studies (Dickerson et al 2010, de Resende et al 2010, Nejad et al 2011, Zhong et al 2012), the present study has shown that PCOS women have similar fertilization rates, good embryo quality rates and clinical pregnancy rates in ART as compared to non-PCOS women (Table 4). A possible reason for this might be that the pituitary suppression treatment necessary for ART have overcome the high LH level in PCOS (Table 3).…”

Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment

“…Moreover, the actual incidence rate of moderate to severe OHSS was significantly higher in the PCOS group (11.5 %) compared to the controls (4.9 %). Such findings are all in line with those reported by others [11,12,14,15]. There was also a trend of higher rate of moderate to severe OHSS in the isolated PCO group (8.2 %) which corresponded to a 67 % risk increment compared to the controls although not reaching statistical significance.…”

“…This echoed the findings in some reported studies [10,[12][13][14][15], while some others have reported higher pregnancy rates in women with PCO compared to controls [9,11]. In contrast to some of the reported studies, our study made use of age-matched controls, which eliminated the confounding effect of age to the treatment outcome.…”

“…On the other hand, some studies have revealed that women having isolated PCO, unlike those with PCOS, do not have altered endocrine and metabolic profile compared to normal controls [12,15,23]. As limited by the retrospective nature of our current study, however, we did not have the metabolic and endocrine data for comparison among the three groups.…”

“…There were a few studies on the IVF outcome of this group [9][10][11][12][13][14][15]. Some of these reported similar pregnancy or live birth rates in the isolated PCO group compared to controls [10,[12][13][14][15], whereas some reported higher pregnancy rates than controls [9,11].…”