Cumulative baby take-home rate among women with PCOS treated by IVF

Kuivasaari-Pirinen, Paula; Hippeläinen, Maritta; Hakkarainen, Heidi; Randell, Kaisa; Heinonen, Seppo

doi:10.3109/09513591003632043

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…Some authors have suggested, though, that oocyte quality lags, resulting in lower implantation, and higher miscarriage rates as well as more aneuploidy [40,41]. Others reported no meaningful outcome differences between PCOS and control patients in IVF cycles [42,43]. Weghofer et al determined that, over all, PCOS patients produce larger euploid embryo numbers, yet still demonstrate lower pregnancy and higher miscarriage rates [44], suggestive of a non-chromosomal quality factor in oocytes.…”

Section: Introductionmentioning

confidence: 99%

The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment?

Gleicher

Weghofer

Barad

2011

Reprod Biol Endocrinol

144

105

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BackgroundEffects of androgens on follicle maturation have been controversial for some time. Here, we review the potential of their applications in improving human ovulation induction, based on human and animal data, reported in the literature.MethodsWe reviewed the published literature for the years 2005-2011, using relevant key words, in PubMed, Medline and Cochrane reviews, and then performed secondary reviews of referenced articles, which previously had not been known or preceded the searched time period. A total of 217 publications were reviewed.ResultsContrary to widely held opinion, recent data, mostly developed in the mouse, convincingly demonstrate essential contribution of androgens to normal follicle maturation and, therefore, female fertility. Androgens appear most engaged at preantral and antral stages, primarily affect granulosa cells, and exert effects via androgen receptors (AR) through transcriptional regulation but also in non-genomic ways, with ligand-activated AR modulating follicle stimulating hormone (FSH) activity in granulosa cells. While some androgens, like testosterone (T) and dehydroepiandrosterone (DHEA), appear effective in improving functional ovarian reserve (FOR) in women with diminished ovarian reserve (DOR), others may even exert opposite effects. Such differences in androgens may, at least partially, reflect different levels of agonism to AR.DiscussionSelective androgens appear capable of improving early stages of folliculogenesis. They, therefore, may represent forerunners of a completely new class of ovulation-inducing medications, which, in contrast to gonadotropins, affect follicle maturation at much earlier stages.

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Section: Introductionmentioning

confidence: 99%

The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment?

Gleicher

Weghofer

Barad

2011

Reprod Biol Endocrinol

144

105

View full text Add to dashboard Cite

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“…Twelve studies reported this outcome (Dor et al, 1990;Kodama et al, 1995;Palep-Singh et al, 2007;Kuivasaari-Pirinen et al, 2010;Swanton et al, 2010;Mellembakken et al, 2011;Kalra et al, 2013;Okohue et al, 2013;Li et al, 2014;Chen et al, 2016;Shi et al, 2018;Hwang et al, 2016). After adjusting for multiple COH cycles, the pooled live birth rate per cycle was (6,465/18,539 (34.9%) in the PCOS group vs 9,315/30,778 (30.3%) in the non-PCOS group; pooled RR = 1.01 [0.89, 1.16]; I 2 = 82%) (Fig.…”

Section: Live Birth Rate (Lbr) Lbr Per Cyclementioning

confidence: 96%

“…A further five studies were awarded a star for similar age (Doldi et al, 1999;Weghofer et al, 2007;Tehrani Nejad et al, 2011;Chen et al, 2016;Shi et al, 2018;Hwang et al, 2016), and one study awarded a star for equivalent BMI (Melado Vidales et al, 2017). Loss to follow-up was reported in only 5 (Hardy et al, 1995;Kuivasaari-Pirinen et al, PCOS group does not meet Rotterdam criteria (Ashkenazi, 1995) Entire cohort already pregnant (Sterling, 2016) Same cohort as another study (Wan, 2015) Differing IVF protocols in PCOS and control group (Dor, 1990) One PCOS criterion used in control group (Kim, 2009) In-vitro maturation used (Le Chen et al, 2016;Shi et al, 2018;Hwang et al, 2016;Almasi-Hashiani et al, 2018) of the 21 studies. We were able to estimate the loss rate from the data provided in six other studies (Urman et al, 1992;Hardy et al, 1995;Weghofer et al, 2007;Mellembakken et al, 2011;Zhong et al, 2012;Li et al, 2014).…”

Section: Assessment Of Biasmentioning

confidence: 99%

“…Six studies reported live birth results per woman following the first cycle (Palep-Singh et al, 2007;Kuivasaari-Pirinen et al, 2010;Swanton et al, 2010;Mellembakken et al, 2011;Li et al, 2014;Chen et al, 2016;Shi et al, 2018). The meta-analysis demonstrated a small but statistically significant difference in the LBR per first cycle between the two study groups: 981/2,582 (38.0%) in the PCOS group vs. 1,513/3,734 (40.5%) in the non-PCOS group; pooled RR = 0.93 [0.88, 0.99]; I 2 = 0% (Fig.…”

Section: Lbr Per First Started Cyclementioning

confidence: 99%

“…Based on 16 contributing studies (Dor et al, 1990;Homburg et al, 1993;Hardy et al, 1995;Kodama et al, 1995;Sengoku et al, 1997;Doldi et al, 1999;Palep-Singh et al, 2007;Weghofer et al, 2007;Kuivasaari-Pirinen et al, 2010;Swanton et al, 2010;Tehrani Nejad et al, 2011;Zhong et al, 2012;Okohue et al, 2013;Li et al, 2014;Chen et al, 2016;Shi et al, 2018;Hwang et al, 2016), women with PCOS had a significantly higher number of oocytes retrieved per cycle (pooled mean difference = 3.6; 95% CI [2.8, 4.4]; I 2 = 85%; Fig. 5) and of oocytes fertilized per cycle (weighted mean difference = 1.2; 95% CI [0.1, 2.3]; I 2 = 88%) than women without PCOS.…”

Section: Oocyte Retrieval and Fertilization Ratesmentioning

confidence: 99%

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Reproductive Outcomes of Women with Polycystic Ovarian Syndrome Following In-Vitro Fertilization — A Meta-Analysis and Systematic Review

Tan

Lim

Indran

et al. 2019

FandR

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Background: Polycystic ovarian syndrome (PCOS) is a common cause of infertility in women. In-vitro fertilization (IVF) is required in 20–30% of women with PCOS trying to conceive. This is associated with increased risk of multiple gestation and ovarian hyperstimulation syndrome. Improvements in IVF techniques, safety standards, and the increased use of frozen embryos in recent years have lead to improved outcomes for women with PCOS. We performed a systematic review and meta-analysis to compare these outcomes with women without PCOS. Search Methods: A search of PubMed, EMBASE, the Cochrane Central Register of clinical trials, and Scopus databases for all articles published until November 16th, 2017 identified 21 studies comparing IVF outcomes in PCOS and non-PCOS women. Inclusion criteria were Rotterdam criteria PCOS, comparable IVF regimes, immediate IVF outcomes, and pregnancy outcomes. Studies were excluded if the control group included any PCOS criteria, donor oocytes, or in-vitro maturation. Outcomes: No difference was observed in live birth rate per cycle in women with vs. without PCOS (RR [Formula: see text] 1.01 [0.89, 1.16]; [Formula: see text] 82%), but the live birth rate per first cycle in PCOS cycles (RR [Formula: see text] 0.93 [0.88, 0.99]) was slightly lower. There was also no difference in the clinical pregnancy rate (RR 1.02 [0.89, 1.17]) or biochemical pregnancy rate (RR 1.03 [0.99, 1.08]) observed between the two groups. PCOS was associated with a significantly higher number of oocytes retrieved (mean difference [Formula: see text] 3.6; 95% CI [2.8, 4.4]), risk of miscarriage (RR 2.90 [2.09, 4.02]), and risk of ovarian hyperstimulation syndrome (RR 3.42 [2.28, 5.13]) per cycle. Conclusion: Despite a widespread perception of poor reproductive potential, women with PCOS experience IVF outcomes similar to those without PCOS. Although there is a slightly lower live birth rate during their first stimulation cycle, success rates are similar after multiple cycles. PCOS is associated with a higher risk of ovarian hyperstimulation syndrome. Further studies are required to mitigate this risk.

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Treatment of infertility in women with polycystic ovary syndrome

Bouchard

2010

Annales d'Endocrinologie

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Cumulative baby take-home rate among women with PCOS treated by IVF

Abstract: Although the baby take-home rate was similar among women with PCOS, and controls, the outcomes of consecutive cycles were not equal. Cumulative data give more realistic information than pooled cycles.

Cited by 16 publications

References 27 publications

The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment?

The role of androgens in follicle maturation and ovulation induction: friend or foe of infertility treatment?

Reproductive Outcomes of Women with Polycystic Ovarian Syndrome Following In-Vitro Fertilization — A Meta-Analysis and Systematic Review

Treatment of infertility in women with polycystic ovary syndrome

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