Characteristics and outcomes of in vitro fertilization in different phenotypes of polycystic ovary syndrome

Abstract

Objective:The aim of this study was to investigate whether polycystic ovary syndrome (PCOS) phenotype without polycystic ovaries (PCO) differs in terms of in vitro fertilization (IVF) outcomes compared with classic phenotypes.Materials and Methods:This retrospective controlled study included 262 patients who underwent IVF treatment with an indication of unexplained or tubal factor infertility (control group), ovulatory patients with PCO morphology (group 1), PCOS phenotype with oligoanovulation and hyperandrogenemia (group 2), PCOS phenotype with PCO morphology and oligoanovulation (group 3). Outcomes and baseline characteristics of IVF-embryo transfer treatments were compared among all groups.Results:PCOS phenotype without PCO morphology had similar IVF stimulation characteristics compared with classic phenotypes; however, a higher total gonadotropin dose was needed to achieve similar results compared with patients with PCO morphology with or without PCOS. Basal follicle-stimulating hormone level (beta coefficient=0.207, p=0.003), group (beta coefficient=-0.305, p<0.001) and age (beta coefficient=0.311, p<0.001) were significantly associated with the total gonadotropin dose. The number of good quality embryo on transfer day was significantly lower in patients with isolated PCO morphology and PCO morphology with oligoanovulation than in those with PCOS phenotype without PCO morphology.Conclusion:PCO morphology provides easier stimulation, whereas hyperandrogenemia provides better results as good quality embryos. However, the end point is similar in terms of biochemical, clinical, and ongoing pregnancy rates.

Assisted reproductive outcomes in women with different polycystic ovary syndrome phenotypes

“…They also demonstrated that AMH concentration is associated with PCOS morphology but could not predict the clinical pregnancy rate and live birth rate . In line with the present study, Selcuk et al . assessed both the features and outcomes of IVF in women with different PCOS phenotypes to clarify the effect of PCO morphology and hyperandrogenemia on outcomes.…”

“…Higher percentages of good quality embryos and the parallel number of dominant follicles demonstrated that hyperandrogenemia may have a positive effect on the aforementioned variable. The authors concluded that patients with PCO morphology stimulate more easily than other PCOS phenotypes and hyperandrogenemia in PCOS women improves the quality of embryos …”

“…The women were categorized into four groups according to the defined criteria as follows: A-hyperandrogenism, chronic anovulation, and polycystic ovaries; B-hyperandrogenism and chronic anovulation but normal ovaries; C-hyperandrogenism and polycystic ovaries but regular ovulatory cycles; and D-chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism. 10 All participants were treated using the GnRH antagonist protocol. Patients received 150 IU recombinant human follicle stimulating hormone (Gonal-F) subcutaneously for 5 days.…”

“…The women were categorized into four groups according to the defined criteria as follows: A—hyperandrogenism, chronic anovulation, and polycystic ovaries; B—hyperandrogenism and chronic anovulation but normal ovaries; C—hyperandrogenism and polycystic ovaries but regular ovulatory cycles; and D—chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism …”

Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes?

“…In the end, the collected data were integrated into the Rotterdam criteria (6). Based on the Rotterdam criteria, four different phenotypes can be defined for PCOS, including hyperandrogenism, chronic anovulation, and polycystic ovaries (PCO); hyperandrogenism and chronic anovulation but normal ovaries; hyperandrogenism and polycystic ovaries but ovulatory cycles; and chronic anovulation and polycystic ovaries but no clinical or biochemical hyperandrogenism (7).…”