Assisted reproduction in polycystic ovarian disease: A multicentric trial in India

Abstract

AIM:The aim of this study is to compare ovarian response, oocyte, embryo quality, ovarian hyperstimulation syndrome incidence, and pregnancy rates in polycystic ovary syndrome (PCOS) and non-PCOS group.MATERIALS AND METHODS:This was a prospective observational study on PCOS carried out in seven assisted reproduction centers in India between August 2008 and July 2010, as part of trial under the Indian Society of Assisted Reproduction. A total of 192 women (77 in the PCOS group and 115 in the non- PCOS group) undergoing in vitro fertilization/intracytoplasmic sperm injection were included. All women had long protocol and recombinant follicle-stimulating hormone stimulation.ANALYSIS:The mean number of follicles and oocytes was higher in PCOS group compared with non-PCOS, being 27.2 (±8.8) and 13.6 (±5.3); 15.9 (±6.3) and 10.9 (±6.2), respectively. The recovery rates of oocytes and mature oocytes per follicle were less in the PCOS group which was 64% and 61.1%, respectively as opposed to 80.3% and 74.5%, respectively in non-PCOS group. The total numbers of top-quality embryos were less in the PCOS group.CONCLUSION:In PCOS women though the number of follicles was more, recovery of mature oocytes, top-quality embryos was less. Pregnancy rates were comparable in both groups.

Ovarian response to controlled ovarian stimulation in women with different polycystic ovary syndrome phenotypes

“…Assisted reproductive techniques (ART) represent the third line of treatment when lifestyle modification and the use of drugs to induce monofollicular ovulation fail; however, controlled ovarian stimulation (COH) in PCOS patients represents a challenge for fertility expert and the major complication remain ovarian hyperstimulation syndrome (OHSS) [6,7]. Additionally, although a great number of oocytes may be retrieved at ovarian pick-up; there are concerns about quality and maturity of these oocytes [8][9][10][11][12][13][14][15]. In our experience, in accordance with recent literature [16], ovarian response to ovarian stimulation vary widely among POCS patients and while some patients are more likely to show resistance to COH, other experienced an exaggerated response.…”

Strategies for improving outcome of assisted reproduction in women with polycystic ovary syndrome: systematic review and meta‐analysis

“…Women with PCOS are typically more difficult to stimulate in a controlled manner, whether the intention is to induce a monofollicular or multifollicular response, are more likely to demonstrate resistance to stimulation and/or an exaggerated response and experience a higher cycle cancellation rate than women without PCOS. While a high number of oocytes may be obtained during ART, there are concerns that the quality and maturity of these oocytes may be compromised. Despite all this, live‐birth rates after ART in women with PCOS seem to be comparable with those of women with other diagnoses, such as endometriosis, unexplained infertility or male factor infertility.…”

Systematic Analysis of Long Noncoding RNA and mRNA in Granulosa Cells during the Hen Ovulatory Cycle

“…Additionally, target genes of DELs involved in oxidative stress were also enriched at the ZT20 stage ( Figure 4 b, Table S6 ). Thus, these findings indicated that oxidative stress and steroid regulation contribute to the ovulatory events [ 54 , 55 ] when the follicle reached the matured phase at the ZT20 stage. Furthermore, up-regulated DEGs at the ZT20 stage (LH surge stage) were also related to inflammatory processes, including acute inflammatory response to antigenic stimulus (GO:0002438), hallmark inflammatory response (M5932), and regulation of inflammatory response (GO:0050727) ( Figure 3 d,e, Table S4 ).…”