In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction

Siristatidis, Charalampos; Vrachnis, Nikos; Creatsa, Maria; Maheshwari, Abha; Bhattacharya, Siladitya

doi:10.1002/14651858.cd006606.pub3

Cited by 43 publications

(26 citation statements)

References 62 publications

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“…A systematic review [120] of head-to-head RCTs aimed to compare IVM followed by IVF/ICSI vs. conventional IVF/ICSI in terms of live birth rate and/or other efficacy and safety maternal/perinatal outcomes did not find any such study. Cha et al [121] firstly reported on obstetric and perinatal outcomes in 41 IVM pregnancies suggesting no adverse effect of the technique.…”

Section: Resultsmentioning

confidence: 99%

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Palomba

Homburg

Santagni

et al. 2016

Reprod Biol Endocrinol

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In the literature, there is growing evidence that subfertile patients who conceived after infertility treatments have an increased risk of pregnancy and perinatal complications and this is particularly true for patients who conceived through use of high technology infertility treatments. Moreover, high technology infertility treatments include many concomitant clinical and biological risk factors. This review aims to summarize in a systematic fashion the current evidence regarding the relative effect of the different procedures for high technology infertility treatments on the risk of adverse pregnancy and perinatal outcome. A literature search up to August 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar and an evidence-based hierarchy was used to determine which articles to include and analyze. Data on prepregnancy maternal factors, low technology interventions, specific procedures for male factor, ovarian tissue/ovary and uterus transplantation, and chromosomal abnormalities and malformations of the offspring were excluded. The available evidences were analyzed assessing the level and the quality of evidence according to the Oxford Centre for Evidence-Based Medicine guidelines and the Grading of Recommendations Assessment, Development, and Evaluation system, respectively. Current review highlights that every single procedure of high technology infertility treatments can play a crucial role in increasing the risk of pregnancy and perinatal complications. Due to the suboptimal level and quality of the current evidence, further well-designed studies are needed.

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Section: Resultsmentioning

confidence: 99%

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Palomba

Homburg

Santagni

et al. 2016

Reprod Biol Endocrinol

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“…Successful fertilisation, embryo development and term pregnancy resulting from IVM oocytes have been reported in women with PCOS 9. Although there has been some concerns about the effectiveness of IVM and the potential for genetic abnormalities in the resulting infants,10–13 there is now growing evidence that pregnancy outcomes after IVM are similar to those after conventional IVF 14.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

Vuong

et al. 2018

BMJ Open

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IntroductionIn vitro maturation (IVM) is a potential alternative to conventional in vitro fertilisation (IVF) to avoid ovarian hyperstimulation syndrome (OHSS). This is particularly relevant in women with a high antral follicle count (AFC) and/or polycystic ovary syndrome (PCOS), who are at increased risk for OHSS. However, no randomised controlled trials of IVM versus IVF in women with high AFC have reported both pregnancy and OHSS rates. The aim of this study is to compare the effectiveness and safety of one IVM cycle and one IVF with segmentation cycle within women with PCOS or high AFC-related subfertility.Methods and analysisThis randomised controlled trial will be conducted at a specialist IVF centre in Vietnam. Eligible subfertile women with PCOS and/or high AFC will be randomised to undergo either IVM or IVF. The primary outcome is live birth after the first embryo transfer of the started treatment cycle. Cycles in which no embryo is available for transfer will be considered as failures. The study has a non-inferiority design, with a maximal acceptable between-group difference of 5%. Rates of OHSS will also be reported.Ethics and disseminationEthical approval was obtained from the participating centre, and informed patient consent was obtained before study enrolment. Results of the study will be submitted for publication in a peer-reviewed journal.Trial registration number NCT03405701; Pre-results.

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“…According to studies that compared the different protocols of IVM in women with PCOS, hCG priming, which was not dose-dependent, raised the maturation rate from 69% to 84%, fertilization rate from 45% to 80%, pregnancy rate from 31% to 38.5%, and live birth rate to 33%. FSH priming increased the pregnancy rate from 0% to 29% [22]. …”

Section: Clinical Regimens In Ivmmentioning

confidence: 99%

In vitromaturation of human oocytes: Its role in infertility treatment and new possibilities

Chang

Song

Lee

et al. 2014

Clin Exp Reprod Med

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IVM refers to the maturation of immature oocytes in culture after their recovery from small antral follicles at the stage prior to selection and dominance. IVM requires little or no FSH in vivo and has been proposed as an alternative to conventional IVF, since it reduces the primary adverse effects caused by controlled ovarian stimulation, including the ovarian hyperstimulation syndrome. Moreover, IVM is a promising option for cases for which no standard protocol is suitable, such as FSH resistance, contraindications for ovarian stimulatory drugs, and the need for urgent fertility preservation. Recently, IVM has been used in women with regular cycles and normal ovaries. However, the pregnancy rate following IVM is suboptimal compared with that of conventional IVF, indicating that further studies to optimize the protocol and the culture conditions are warranted.

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In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction

Cited by 43 publications

References 62 publications

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review

Effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilisation in women with high antral follicle count: study protocol for a randomised controlled trial

In vitromaturation of human oocytes: Its role in infertility treatment and new possibilities

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