Obstetric outcome of patients with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization and embryo transfer

Abstract

ObjectiveTo assess the obstetric outcome of pregnancies resulting from in-vitro maturation (IVM) and in-vitro fertilization and embryo transfer (IVF-ET) of immature oocytes retrieved from women with polycystic ovarian syndrome (PCOS).DesignProspective observational study.Materials and methodsPatient(s): One hundred and thirty-nine women undergoing 203 in-vitro oocyte maturation treatment cycles. Intervention(s): Immature oocyte recovery from unstimulated ovaries. In-vitro oocyte maturation (IVM) and fertilization. Fresh embryo transfer and assessment of obstetrical outcomes in the pregnant women. Main outcome Measure(s): Pregnancy and obstetric outcome.ResultsFourty-one pregnancies were obtained in 187 embryo transfers, resulting in a pregnancy rate (PR) of 21.9%. Except for 3 cases lost to follow up in these pregnancies, the abortion rate (AR) and live birth rate (LBR) were 36.8%(14/38) and 63.2% (24/38). The mean gestational age and mean birth weight at delivery for singletons was 38.4±2.0 weeks[range:33∼41.6 weeks] and 3252±516gm[range:1750∼4100gm], respectively. For twins this was 36.7±1.9 weeks[range:34.6∼39weeks] and 2361±304gm[range:1900∼2990gm], respectively. Pregnancy complications occurred in 5 cases (13.2%), this included preterm labor (n=3) and placenta previa (n=2). Two cases (5.3%) had a major congenital anomaly diagnosed by ultrasonography.ConclusionThe abortion rate, gestational age and birth weight at delivery, and obstetric complications of pregnancies conceived by IVM-ET were comparable to those of other women with PCOS being treated by conventional IVF-ET. IVM followed by IVF-ET appears to be a useful treatment option for women with PCOS, thus avoiding the risk of OHSS. ObjectiveTo assess the obstetric outcome of pregnancies resulting from in-vitro maturation (IVM) and in-vitro fertilization and embryo transfer (IVF-ET) of immature oocytes retrieved from women with polycystic ovarian syndrome (PCOS). To assess the obstetric outcome of pregnancies resulting from in-vitro maturation (IVM) and in-vitro fertilization and embryo transfer (IVF-ET) of immature oocytes retrieved from women with polycystic ovarian syndrome (PCOS). DesignProspective observational study. Prospective observational study. Materials and methodsPatient(s): One hundred and thirty-nine women undergoing 203 in-vitro oocyte maturation treatment cycles. Intervention(s): Immature oocyte recovery from unstimulated ovaries. In-vitro oocyte maturation (IVM) and fertilization. Fresh embryo transfer and assessment of obstetrical outcomes in the pregnant women. Main outcome Measure(s): Pregnancy and obstetric outcome. Patient(s): One hundred and thirty-nine women undergoing 203 in-vitro oocyte maturation treatment cycles. Intervention(s): Immature oocyte recovery from unstimulated ovaries. In-vitro oocyte maturation (IVM) and fertilization. Fresh embryo transfer and assessment of obstetrical outcomes in the pregnant women. Main outcome Measure(s): Pregnancy and obstetric outcome. ResultsFourty-one pregnancies were obtained in 187 embryo transfers, resulting in a pregnancy rate (PR) of 21.9%. Except for 3 cases lost to follow up in these pregnancies, the abortion rate (AR) and live birth rate (LBR) were 36.8%(14/38) and 63.2% (24/38). The mean gestational age and mean birth weight at delivery for singletons was 38.4±2.0 weeks[range:33∼41.6 weeks] and 3252±516gm[range:1750∼4100gm], respectively. For twins this was 36.7±1.9 weeks[range:34.6∼39weeks] and 2361±304gm[range:1900∼2990gm], respectively. Pregnancy complications occurred in 5 cases (13.2%), this included preterm labor (n=3) and placenta previa (n=2). Two cases (5.3%) had a major congenital anomaly diagnosed by ultrasonography. Fourty-one pregnancies were obtained in 187 embryo transfers, resulting in a pregnancy rate (PR) of 21.9%. Except for 3 cases lost to follow up in these pregnancies, the abortion rate (AR) and live birth rate (LBR) were 36.8%(14/38) and 63.2% (24/38). The mean gestational age and mean birth weight at delivery for singletons was 38.4±2.0 weeks[range:33∼41.6 weeks] and 3252±516gm[range:1750∼4100gm], respectively. For twins this was 36.7±1.9 weeks[range:34.6∼39weeks] and 2361±304gm[range:1900∼2990gm], respectively. Pregnancy complications occurred in 5 cases (13.2%), this included preterm labor (n=3) and placenta previa (n=2). Two cases (5.3%) had a major congenital anomaly diagnosed by ultrasonography. ConclusionThe abortion rate, gestational age and birth weight at delivery, and obstetric complications of pregnancies conceived by IVM-ET were comparable to those of other women with PCOS being treated by conventional IVF-ET. IVM followed by IVF-ET appears to be a useful treatment option for women with PCOS, thus avoiding the risk of OHSS. The abortion rate, gestational age and birth weight at delivery, and obstetric complications of pregnancies conceived by IVM-ET were comparable to those of other women with PCOS being treated by conventional IVF-ET. IVM followed by IVF-ET appears to be a useful treatment option for women with PCOS, thus avoiding the risk of OHSS.