Endocrinology: High incidence of embryo transfer cancellations in patients with polycystic ovarian syndrome

Abstract

This study was aimed at assessing the outcome of in-vitro fertilization (IVF) and embryo transfer in patients with polycystic ovarian syndrome (PCOS). The results of IVF and embryo transfer in PCOS patients (PCOS group, 78 cycles of 26 patients) were compared with those of a control group (423 cycles in 202 patients without male factor; age and ovarian stimulation protocol were matched). Although the pregnancy rate per transfer was not different in the two groups of patients (25 versus 34%, PCOS versus control group), the PCOS group had a significantly lower pregnancy rate per follicle aspiration (19 versus 31%, P < 0.05). A notable result was a significantly higher incidence of embryo transfer cancellations in the PCOS group (22 versus 8%, P < 0.01), which resulted from unpredictable failure of either oocyte recovery or fertilization. The incidence of unexplained complete failure of fertilization was significantly higher in the PCOS group (18 versus 5%, P < 0.01). These results may reflect a reduced quality of the oocytes in the PCOS group, and there was a subgroup of PCOS patients who repeatedly produced poor results of treatment. Although the ovarian stimulation regimen best suited to PCOS patients remains to be determined, special care should be taken during ovarian stimulation, especially when the PCOS patients had experienced unexplained failure of oocyte recovery or fertilization in the previous treatment cycle(s).

Uterine blood flow in pregnant patients with polycystic ovary syndrome: relationships with clinical outcomes

“…1,2 The impact that the syndrome has on human reproduction does not only include anovulatory infertility, but also detrimental effects on oocyte [3][4][5][6] and embryo 7 quality, endometrial receptivity, 8,9 and pregnancy development. 10 Retrospective [11][12][13][14][15] and prospective [16][17][18] noncontrolled data designated PCOS as a risk factor for increased incidence of complications throughout pregnancy.…”

Spindle and chromosome configurations of in vitro-matured oocytes from polycystic ovary syndrome and ovulatory infertile women: a pilot study

“…Studies that have evaluated oocyte quality in patients with PCOS in a noninvasive manner have used the analysis of parameters such as the number of metaphase II oocytes [5,10] and morphological analysis of the cumulus-oocyte complex [11,12]. However, in view of the weak correlation of these parameters with subsequent embryo development and consequently with the prognosis of pregnancy, these criteria are assumed not to be adequate predictors of the real oocyte quality.…”

Effect of Follicular Fluid Oxidative Stress on Meiotic Spindle Formation in Infertile Women with Polycystic Ovarian Syndrome

“…The adverse effects of the varied endocrine and metabolic disturbances in PCOS pose a significant challenge in the treatment of infertility in these patients, even while undergoing in vitro fertilization and embryo transfer (IVF-ET). Elevated levels of LH and obesity have often been implicated in the poor pregnancy and higher miscarriage rates encountered in PCOS patients undergoing assisted conception [3,4] whereas high intrafollicular testosterone levels have been associated with meiotically incompetent oocytes [5] with a lower fertilization potential. Recent studies have shown that, apart from endocrinopathy, PCOS is also associated with excessive oxidative stress (OS) [6] and increased levels of TNF-␣ [7] .…”