Oocyte quality in polycystic ovaries revisited: Identification of a particular subgroup of women

Cano, Fidel; García-Velasco, Juan A.; Millet, Antón; Remohı́, José; Simón, Carlos; Pellicer, António

doi:10.1007/bf02765826

Cited by 91 publications

(56 citation statements)

References 28 publications

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“…The higher number of embryos transferred in the group aged 35 years and above is a natural outcome of transferring more embryos at advanced ages. Whether in PCOS patients, it is a generally accepted fact in the literature that advanced maternal age has a negative effect on all parameters in IVF cycles (14,(26)(27)(28)(29). In the present study, although a statistically significant difference could not be demonstrated, it was seen that all parameters were negatively affected in the group aged 35 years and above.…”

Section: Discussionmentioning

confidence: 99%

Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome

Kalem

Sarı

et al. 2016

J Turkish German Gynecol Assoc

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Results:Variations in cycle variables with BMI and age showed that IVF cycles were negatively affected by increases in obesity and age. Clinical pregnancy rates were found to be lower in the obese group than in the other groups, particularly in the age group above 35 years; however, this difference could not be proven statistically. Conclusion:The present study evaluated obesity and clinical pregnancy rates in IVF cycles in PCOS patients according to age groups, and particularly in the obese group, the clinical pregnancy rates were observed to be lower in the age group ≥35 years than in the other BMI groups; however, this difference was found to be statistically insignificant. (J Turk Ger Gynecol Assoc 2016; 17: 83-90) Keywords: PCOS, body mass index, age, IVF outcome Received: 31 December, 2015 Accepted: 8 March, 2016 Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome Bailey et al. (12) investigated the effect of BMI on the characteristics and outcomes of IVF cycles in PCOS and found lower clinical pregnancy rates in an obese PCOS group than in a lean group and a lower rate of ovarian hyperstimulation syndrome (OHSS) in the obese group. A woman's age is also an important factor in IVF success (13,14). The IVF success rate reduces with increasing age in PCOS, as in all infertile patient groups (15, 16). The literature contains a very limited number of studies that investigate age and BMI together. Heijnen et al. (17) reported that although BMI has a significant and negative effect on female fertility, this effect gradually decreases as women approach their mid-thirties and also in younger women receiving IVF. Above the age of 36 years, on the other hand, the effect of BMI on fertility becomes minimal. PCOS patients were not included in this study. The study by Metwally et al. (8) that investigated 426 IVF/ICSI cycles did not exclude PCOS patients and reported that although obesity does not affect oocyte quality, there is a reduction in embryo quality in patients under the age of 35 years. The hypothesis of the present study assumed that the effect of BMI on the IVF cycles of PCOS patients may vary with age. The present study aimed to investigate age-related variations in the effect of BMI on IVF outcomes. Material and MethodsThis was a cohort study conducted by retrospectively investigating the IVF cycles of 653 PCOS patients under the age of 40 years, who were diagnosed based on the Rotterdam criteria in Gürgan IVF clinic between 2005 and 2015. The study protocol was approved by the local ethics committee, and all patients included in the study provided informed consent. The patients were diagnosed with PCOS in accordance with the diagnostic criteria of the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine Rotterdam Consensus Meeting 2003 (18). Based on this set of criteria, two of the following three criteria are necessary for confirming a diagnosis: -Anovulation or Oligoovulation -Biochemical or Clinical Hyperandr...

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Section: Discussionmentioning

confidence: 99%

Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome

Kalem

Sarı

et al. 2016

J Turkish German Gynecol Assoc

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“…Compounding the effects of PCOS, 50% of patients with PCOS also have a BMI associated with obesity; more than the average population [8]. Obese women with PCOS who also have hyperinsulinemia and impaired glucose tolerance are reported to have decreased fertilization and implantation rates compared to women with PCOS alone [9]. Morbidly obese women (BMI ≥40 kg/m) with PCOS have significantly lower pregnancy rates than women with PCOS alone [10].…”

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confidence: 99%

The impact of obesity on egg quality

Purcell

Moley

2011

J Assist Reprod Genet

132

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Obesity in women is a concern in many countries. This causes numerous health issues; however, this review focuses on the impact of obesity on women's reproduction, and in particular the oocyte. Data from infertility clinics and experimental animal models that address the effects of obesity are presented. Bidirectional communication and metabolic support from the surrounding cumulus cells are critical for oocyte development, and the impact of obesity on these cells is also addressed. Both oocyte maturation and metabolism are impaired due to obesity, negatively impacting further development. In addition to reproductive hormones, obesity induced elevations in insulin, glucose, or free fatty acids, and changes in adipokines appear to impact the developmental competence of the oocyte. The data indicate that any one of these hormones or metabolites can impair oocyte developmental competence in vivo, and the combination of all of these factors and their interactions are the subject of ongoing investigations.

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“…Oocytes picked-up in the PCOS IVF cycles were reported to be great in numbers, but high-quality oocytes were reported to be insufficient. These cycles occur with low blastocyst formation rates, and high embryonic fragmantation rates; they also possess low rates of fertilization and implantation (51). High E2 levels in the PCOS cases may lead to defects in oocyte maturation and embryonic development (52).…”

Section: Introductionmentioning

confidence: 99%

“…Hypersecretion of LH in the folliculogenesis induces atresia of the small antral follicles and the premature luteinization of the granulosa cells, leading to disordered granulosa cell functions, which results in the suppression of the oocyte maturation inhibitors, and thus causes premature maturation of the oocytes. Oocyte maturation disordered by the high LH in this way, results in low fertilization rate, low-quality embryos, followed by low pregnancy rates and high rates of early losses (51,56). In addition, LH activates premature meiotic development by damaging the oocyte nucleus, and disordered endocrine control of the meiosis also damages the first polar body extrusion, which results in the final damage of the oocyte chromosomal configuration.…”

Section: Introductionmentioning

confidence: 99%

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Problems and Complications During the Treatment of Infertility in Women with Polycystic Ovary Syndrome

Kalem

Gürgan

2016

Gynecol Obstet Reprod Med

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Polycystic ovary syndrome (PCOS) is the most frequent endocrine disorder existing in women in their reproductive years and it is one of the most evaluated and discussed subjects of reproductive medicine with regard to its diagnosis and treatment.Patients with PCOS constitute the most difficult population in the management of infertility. The factors that increase the success rates in the treatment of PCOS infertility are: pretreatment changes in life style, dietetic and psychological support, a detailed evaluation of the couple and the appropriate selection of the treatment protocol, a wide-spectrum approach to maintaining ovarian and endometrial synchronization in the management of the cycle, and well-developed laboratory conditions to support embryonic quality. However, even if these conditions are provided, OHSS, cancellations of the cycle, poor oocyte, and embryo qualities, unsuccessful fertilization and implantation, chromosomal abnormalities and early losses may still be experienced.

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Oocyte quality in polycystic ovaries revisited: Identification of a particular subgroup of women

Cited by 91 publications

References 28 publications

Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome

Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome

The impact of obesity on egg quality

Problems and Complications During the Treatment of Infertility in Women with Polycystic Ovary Syndrome

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