Oocyte quality and embryo quality of infertile women with polycystic ovarian syndrome

Abstract

OBJECTIVE: To investigate the oocyte and embryo quality of infertile women with polycystic ovarian syndrome (PCOS), isolated polycystic ovaries morphology (PCO-only) or matched control group undergoing IVF-ET. DESIGN: A retrospective case-control study. MATERIALS AND METHODS: 486 IVF/ ICSI cycles were performed from January 2003 to January 2008. The diagnosis of PCOS was based on Rotterdam criteria. Three study groups were identified: PCOS group (202 cycles), PCO-only group (PCO-only morphology, 134 cycles) and control group (normal ovarian response and age-matched,150 cycles). Oocyte and embryo morphorlogy, including perivitelline space, polar body, granular cytoplasm, smooth endoplasmic reticulum incidence, vacuolization and abnormal zona pellucida, were recorded. Pregnancy outcome were analyzed. RESULTS: Compared with control group, lower maturity rate of oocytes, lower fertilization rate, and fewer number of high-grade embryos were attained in PCOS and PCO-only groups, although more oocytes were retrieved and lower total dose of gonadotropin were administrated (P<0.01). The percentage of transferred two high-quality embryo and total embryo score were lower in PCOS and PCO-only group compared to control group (P<0.05). There were no significant differences of the rate of abnormal perivitelline space, abnormal polar body, abnormal granular cytoplasm, smooth endoplasmic reticulum incidence, vacuolization and abnormal zona pellucida among the three groups in ICSI cycles (P>0.05). But total rate of MII oocyte morphology abnormality was significantly higher in PCOS and PCO-only group compared with control group (P<0.05). Clinical pregnancy were 51.0%, 53.0% and 46.0% in PCOS, PCO-only and control groups, respectively. No significant differences were noted in the implantation and pregnancy rates among the three groups. However the clinical miscarriage rate was significantly higher in women with PCOS group (15.4%) than that in the PCO-only morphology group (5.5%) and control group(5.8%)(P < 0.05). CONCLUSIONS: Infertile women with PCOS have shown to have similar characteristics to women with PCO-only in terms of ovarian response to Gn stimulation, oocyte and embryo quality and pregnancy rates. Oocyte morphology abnormality and embryo quality may be associated with early miscarriage rates in PCOS. It suggested that factors related to oocyte and embryo morphology present in PCOS patients may be instrumental in adverse reproductive outcomes in these women.