Polycystic ovary syndrome phenotype does not have impact on oocyte morphology

Audrey Uk,Hélène Béhal,Anne-Laure Barbotin,Christine Decanter,Didier Dewailly,Camille Grysole,Mauro Silva,Laura Keller,Geoffroy Robin

doi:10.1186/s12958-021-00874-2

Abstract

PurposeThe primary objective of the present study of women participating in an ICSI program was to determine whether the morphologic quality of oocytes was related to the polycystic ovary syndrome (PCOS) phenotype.MethodsWe performed a retrospective cohort study in the IVF unit at the Lille University Medical Center (Lille, France) between 2006 and 2015. Oocyte morphology (fragmented first polar body, abnormal zona pellucida, large perivitelline space, material in perivitelline space, abnormal shape of oocyte, granular cytoplasm and intracytoplasmic vacuoles) was evaluated in PCOS women and according to different subgroup (depending on the presence or absence of the cardinal features polycystic ovarian morphology (PCOM), hyperandrogenism (HA), and oligo-anovulation (OA)).ResultsA total of 1496 metaphase II oocytes (n = 602 for phenotype A combining PCOM + HA + OA, n = 462 oocytes for phenotype C: PCOM + HA, and n = 432 for phenotype D: PCOM + OA) were assessed. The phenotypes A, C and D did not differ significantly with regard to the proportion of normal oocytes (adjusted percentages (95%CI): 35.2% (31.5 to 39.1%), 25.8% (21.9 to 29.9%) and 34.0% (29.7 to 38.6%), respectively: adjusted p = 0.13). Likewise, there were no significant intergroup differences in oocyte morphology. The ICSI outcome was not significantly associated with the PCOS phenotype.ConclusionThe present study is the first to show that the PCOS phenotype (notably the presence vs. absence of OA and/or HA) is not significantly associated with the morphological quality of oocytes.

Highlights

Polycystic ovary syndrome (PCOS) is the most common endocrine reproductive disorder; worldwide, it affects 5-20% of women of reproductive age [1]
It is suspected that these PCOS oocytes may be of poor quality as a result of intra- and extra-ovarian factors [12]; this might lead to a lower fertilization rate, poor embryo quality, a lower implantation rate and a higher miscarriage rate [8,9,10, 13, 14]
The inclusion criteria for this group were (i) age 18–38, (ii) Polycystic ovarian morphol‐ ogy (PCOM) defined as either an ovarian volume ≥ 10 ml, an ovarian surface area ≥ 5.5 cm2, a follicle number per ovary (FNPO) ≥19 or an Anti-Müllerian hormone (AMH) level ≥ 35 pmol/l or both [28], (iii) the presence of at least one controlled ovarian hyperstimulation (COH) procedure followed by successful oocyte retrieval; and (iv) inclusion in an Intracytoplasmic sperm injection (ICSI) program in a sole indication of male infertility

Summary

Introduction

Polycystic ovary syndrome (PCOS) is the most common endocrine reproductive disorder; worldwide, it affects 5-20% of women of reproductive age [1]. In a study of IVF procedures, Ramezanali and colleagues (2016) reported lower clinical pregnancy rates in PCOS phenotypes A and B than in controls - suggesting that the combination of HA and OA may affect embryonic development [18]. Several studies have found that the oocyte’s developmental competence might be impaired in women with PCOS [12, 20]. Alikani and colleagues reported reduced pregnancy and implantation rates in women with exclusive replacement of embryos, originating from dysmorphic oocytes regardless of the oocyte abnormality features [21]. Oocyte quality is a key limiting factor in female fertility; it reflects the oocyte’s intrinsic developmental potential and has an essential role in fertilization and subsequent development [23]

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