Abstract
Objective:The aim of this study was to investigate whether polycystic ovary syndrome (PCOS) phenotype without polycystic ovaries (PCO) differs in terms of in vitro fertilization (IVF) outcomes compared with classic phenotypes.Materials and Methods:This retrospective controlled study included 262 patients who underwent IVF treatment with an indication of unexplained or tubal factor infertility (control group), ovulatory patients with PCO morphology (group 1), PCOS phenotype with oligoanovulation and hyperandrogenemia (group 2), PCOS phenotype with PCO morphology and oligoanovulation (group 3). Outcomes and baseline characteristics of IVF-embryo transfer treatments were compared among all groups.Results:PCOS phenotype without PCO morphology had similar IVF stimulation characteristics compared with classic phenotypes; however, a higher total gonadotropin dose was needed to achieve similar results compared with patients with PCO morphology with or without PCOS. Basal follicle-stimulating hormone level (beta coefficient=0.207, p=0.003), group (beta coefficient=-0.305, p<0.001) and age (beta coefficient=0.311, p<0.001) were significantly associated with the total gonadotropin dose. The number of good quality embryo on transfer day was significantly lower in patients with isolated PCO morphology and PCO morphology with oligoanovulation than in those with PCOS phenotype without PCO morphology.Conclusion:PCO morphology provides easier stimulation, whereas hyperandrogenemia provides better results as good quality embryos. However, the end point is similar in terms of biochemical, clinical, and ongoing pregnancy rates.
Highlights
Polycystic ovary syndrome (PCOS) is a complex disorder and may present in different phenotypes
The aim of this study was to investigate whether polycystic ovary syndrome (PCOS) phenotype without polycystic ovaries (PCO) differs in terms of in vitro fertilization (IVF) outcomes compared with classic phenotypes
Materials and Methods: This retrospective controlled study included 262 patients who underwent IVF treatment with an indication of unexplained or tubal factor infertility, ovulatory patients with PCO morphology, PCOS phenotype with oligoanovulation and hyperandrogenemia, PCOS phenotype with PCO morphology and oligoanovulation
Summary
Polycystic ovary syndrome (PCOS) is a complex disorder and may present in different phenotypes. Previous data included only the classic phenotype characterized by chronic anovulation and hyperandrogenism[1,2,3]. Hyperandrogenism, chronic anovulation, and polycystic ovaries (PCO); II. Chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism. A meta-analysis concluded that unknown intra-or extraovarian abnormalities may interfere with granulosa cell-oocyte interaction, oocyte maturation, and potential embryonic development and result in unsuccessful artificial reproduction techniques in PCOS[5]. It is not known whether different phenotypes of PCOS have similar results. According to the aforementioned data, we know that all PCOS phenotypes do not have hyperandrogenemia or even PCO morphology, so is it possible to generalize all in vitro fertilization (IVF) outcomes in PCOS by assessing a mixture of women with different PCOS phenotypes? In this study, we aimed to assess IVF characteristics among different PCOS phenotypes to show whether PCO morphology or hyperandrogenemia would interfere with the results
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