Embryos from polycystic ovary syndrome patients with hyperandrogenemia reach morula stage faster than controls

Abstract

Objective: To investigate if patients with polycystic ovary syndrome (PCOS) have altered embryo morphokinetics when compared with controls. Design: Retrospective cohort analysis. Setting: Single academic fertility clinic in a tertiary hospital setting. Patient(s): Age-and body mass index-matched patients who underwent in vitro fertilization diagnosed with PCOS using the Rotterdam criteria. A subanalysis was performed on patients with PCOS with hyperandrogenemia. Sixty-four patients with PCOS were identified with 990 embryos that were matched with 64 control patients with 628 embryos. Intervention(s): None. Main Outcome Measure(s): Time to blastulation. Result(s): Embryos from women with PCOS displayed faster growth rate at t7, t8, and t9; all other morphokinetic points were similar. Patients with PCOS also had a higher number of oocytes retrieved. No differences were seen in the fertilization rate or blastulation rate. Patients with PCOS had a higher miscarriage rate (38.1% in PCOS vs. 18.8% in controls). Patients with hyperandrogenic PCOS showed a faster growth rate at t5, t6, t7, t8, t9, and morula. Conclusion(s): Embryos from women with PCOS grew faster until 9-cell stage and women with hyperandrogenic PCOS until morula. Patients with PCOS also showed a higher miscarriage rate. The alterations in early embryo development are consistent with altered fertility and obstetric outcomes in the population with PCOS and may be due to the hyperandrogenic microenvironment in the ovarian follicle. (Fertil Steril Rep Ò 2020;1:125-32. Ó2020 by American Society for Reproductive Medicine.

Correlations between Follicular fluid PlGF and IVF/ICSI outcomes among polycystic ovary syndrome women and normo-ovulatory women using different controlled hyperstimulation protocols

“…Similarly, A at 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 embryos development ended up with contradicted results [5,[53][54][55]. The study of Chappell et al [53] showed that embryos from PCOS women displayed a faster growth rate at t7, t8, and t9 compared to controls, while those from hyperandrogenic PCOS showed a faster growth rate at t5, t6, t7, t8, t9, and morula stage.…”

“…However, time-lapse studies on embryos development ended up with contradicted results [5,[53][54][55]. The study of Chappell et al [53] showed that embryos from PCOS women displayed a faster growth rate at t7, t8, and t9 compared to controls, while those from hyperandrogenic PCOS showed a faster growth rate at t5, t6, t7, t8, t9, and morula stage. Similarly, Sundvall et al [54] reported a shorter time to initiate compaction and reach the morula stage; and a shorter duration of the fourth cleavage division in the PCOS embryos compared with the non-PCOS ones, but the kinetic at other time-points were similar.…”

Mitofusins: from mitochondria to fertility

“…This suggests that the specific regulation of Mfn2 expression levels in the sperm of patients might help to alleviate asthenozoospermia and the reduction in progressive sperm motility caused by mitochondrial dysfunction. In females, PCOS is one of the most common diseases that affect women with abnormal endocrine and metabolic conditions that are characterized by ovulatory dysfunction and hyperandrogenemia; the main characteristics are an irregular menstrual cycle and infertility [ 155 , 156 ]. Previous research in PCOS mice showed that mitochondrial fusion/division was disturbed, the levels of ROS were increased, Mfn2 expression was significantly reduced (Fig.…”

Hyperandrogenemia alters mitochondrial structure and function in the oocytes of obese mouse with polycystic ovary syndrome

“…We recently showed that embryos from women with hyperandrogenic PCOS grew faster until morula (12). Interestingly, patients with PCOS also showed a higher miscarriage rate, which strongly indicates that a hyperandrogenic ovarian microenvironment could alter fertility and obstetric outcomes (13).…”