Does polycystic ovary syndrome affect morphokinetics or abnormalities in early embryonic development?

Abstract

Objectives This study aimed to investigate whether oocyte retrieval from PCOS patients affects the morphokinetics or the incidence of abnormalities in early embryonic development, using time-lapse imaging analysis. Methods This was a prospective study in total of 39 PCOS patients and 67 women with normal ovarian function, underwent a GnRH antagonist protocol of controlled ovarian stimulation and fertilization by ICSI. 402 zygotes from the PCOS group and 449 zygotes from the control group were observed by time-lapse monitoring for 48 h following sperm injection. Results Patients with PCOS showed a significantly higher number of retrieved oocytes, and a significantly higher number of metaphase II oocytes per cycle than that of the non-PCOS group (18.85 ± 9.41 vs. 11.48 ± 5.51 and 14.97 ± 7.43 vs. 9.51 ± 4.7, respectively). However, oocyte maturation rate and morphologically assessed embryo quality did not differ between two groups. After 48 h of the embryo culture using time-lapse video recording, most of the embryos in both groups had reached the 4-cell stage (353/449 vs. 314/402 embryos). There were no significant differences between the control and PCOS group regarding the time-points of the successive events in early embryonic development from the appearance of 2 polar bodies to the 6-cell stage. However, the percentage of t2 stages which fell in “optimal range” (>24 h and ≤28 h) was significantly lower in the PCOS group than in the control group (37.8% vs. 48.1%, P = 0.004). The proportion of embryos manifesting abnormal fertility, multinucleation, direct cleavage and reverse cleavage were not significantly different between the two groups. Conclusion Our data indicated that PCOS does not affect the morphokinetics or incidence of abnormalities in early embryonic development.

Follicular fluid PlGF and IVF/ICSI outcomes among PCOS and normo-ovulatory women using different controlled hyperstimulation protocols: A prospective case-control study

“…However, Nikbakht et al [ 6 ] did report the total stimulation doses that were used in the studied groups. Although the women of the PCOS-Anta group of our study and Le et al study [ 5 ] were stimulated with similar doses, women in the Control-Anta group of our study were stimulated with a little higher dosage of gonadotropins compared to those from Le et al study [ 5 ] and produced higher number of retrieved oocytes. Thus, the increase in stimulators dose did not arise from a lower response to gonadotropins.…”

“…On the other side, our results on the GnRH antagonist protocol were consistent with the results of the prospective study of Afiat et al [ 7 ], which could not detect any significant differences in the number of MII oocytes and MI oocytes between PCOS (n = 50) and controls (n = 50) that treated with GnRH antagonist protocol. Differently, the prospective study of Le et al [ 5 ] showed higher numbers of retrieved oocytes and mature oocytes in the PCOS group (n = 39) compared to the control one (n = 67) during the GnRH antagonist protocol. Similarly, the retrospective study of Nikbakht et al [ 6 ] also found a higher number of retrieved oocytes in the PCOS group.…”

“…In our study, women in the PCOS-Anta group were stimulated with (1779.55 ± 702.87) IUs and provided (17.73 ± 9.76) oocytes and (10.18 ± 5.55) MII oocytes while the Control-Anta were stimulated with (2468.18 ± 879.53) IUs and provided (16.24 ± 8.99) oocytes and (9.03 ± 5.34) MII oocytes. On the other hand, during Le et al study [ 5 ], women in the PCOS-Anta group were stimulated with (1820.69 ± 332.06) IUs and provided (18.85 ± 9.41) oocytes and (14.97 ± 7.43) MII oocytes while in the Control-Anta were stimulated with (2005.60 ± 379.69) IUs and provided (11.48 ± 5.51) oocytes and (9.51 ± 4.7) MII oocytes. However, Nikbakht et al [ 6 ] did report the total stimulation doses that were used in the studied groups.…”

“…Similarly, Afiat et al [ 7 ] reported comparable oocyte nuclear maturity and embryo grades between PCOS and non-PCOS women during the GnRH antagonist protocol. However, time-lapse studies on embryo development ended up with contradicted results [ 5 , [54] , [55] , [56] ]. The retrospective study of Chappell et al [ 54 ] showed that embryos from PCOS women (n = 64 women) displayed a faster growth rate at t7, t8, and t9 compared to controls (n = 64 women), while those from hyperandrogenic PCOS (n = 47 women) showed a faster growth rate at t5, t6, t7, t8, t9, and morula stage.…”

“…In-vitro Fertilization/Intra-Cytoplasmic Sperm Injection (IVF/ICSI) technologies are usually added to the plan-therapy of PCOS women as a third-line treatment choice after the failure of other approaches of ovulation induction [ 4 ]. However, since the long Gonadotropin-releasing hormone (GnRH) agonist protocol is still the first-line choice in most of the infertility clinics, only limited and conflicted data are available about the impact of PCOS on the IVF/ICSI outcomes during the GnRH antagonist protocols [ [5] , [6] , [7] ]. In addition, no previous study has investigated in detail the impact of PCOS on the oocyte morphology during both the long GnRH agonist protocol and the flexible GnRH antagonist one.…”