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.
Highlights
The latest advances in ultrasonic measurement techniques have helped indentify that 20∼30% women have polycystic ovaries (PCO) [1]
Contrary to some reports [4,5,6], in the current study, we found that body mass index (BMI) and levels of luteinizing hormone (LH) and androgen were similar between the ovulatory PCO and normal ovaries (NO) patients, which were significantly higher than those in the polycystic ovary syndrome (PCOS) patients
Insulinsensitizing agent metformin which has been examined as a cotreatment during in vitro fertilization (IVF) in women with PCOS, brought an increase in pregnancy rate [19] and a significant reduction in rates of ovarian hyperstimulation syndrome (OHSS) [20], for women with PCO but no other manifestations of PCOS, metformin cotreatment before and during IVF did not bring any positive effect in clinical pregnancy, live birth, or severe OHSS [21]
Summary
The latest advances in ultrasonic measurement techniques have helped indentify that 20∼30% women have polycystic ovaries (PCO) [1]. A subpopulation of these PCO cases is ovulatory PCO [3], in which women do not display any typical symptom of the polycystic ovary syndrome (PCOS) they do have PCO. A recent study demonstrates that isolated PCO is an age-dependent, normal finding among ovulatory women that has no pathologic or clinical significance [7]. The aim of the present study was to directly address this deficiency in the literature and compare the ovulation and treatment of IVFET among patients suffering from PCOS, ovulatory PCO, or normal ovaries with other complications (NO)
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