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Erschienen in: Journal of Assisted Reproduction and Genetics 2/2014

01.02.2014 | Assisted Reproduction Technologies

Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment

verfasst von: Hang Wun Raymond Li, Vivian Chi Yan Lee, Estella Yee Lan Lau, William Shu Biu Yeung, Pak Chung Ho, Ernest Hung Yu Ng

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 2/2014

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Abstract

Purpose

This retrospective cohort study evaluated the cumulative live birth rate in women with polycystic ovary syndrome (PCOS) and isolated polycystic ovaries (PCO) undergoing in-vitro fertilisation (IVF) treatment.

Methods

We studied 104 women with PCOS, 184 with PCO and 576 age-matched controls undergoing the first IVF treatment cycle between 2002 and 2009. The main outcome measure was cumulative live birth in the fresh plus all the frozen embryo transfers combined after the same stimulation cycle.

Results

Women in both the PCOS (n = 104) and isolated PCO groups (n = 184) had higher ovarian response parameters compared to age-matched controls (n = 576), and higher rates of withholding fresh embryo transfer for risk of ovarian hyperstimulation syndrome (OHSS). The actual incidence of moderate to severe OHSS was significantly higher in the PCOS (11.5 %) but not the isolated PCO group (8.2 %) compared to controls (4.9 %). The live birth rates in the fresh cycle were comparable among the 3 groups, but the PCOS group had a significantly higher miscarriage rate compared to the other 2 groups. Cumulative live birth rate was significantly higher in the isolated PCO group (60.3 %), but not the PCOS group (50.0 %), compared to controls (47.5 %).

Conclusions

Women in the isolated PCO group, but not the PCOS group, had a significantly higher cumulative live birth rate compared to controls. This could be explained by the quantitative effect of the higher number of transferable embryos obtained per stimulation cycle, which is uncompromised by the unfavourable embryo competence otherwise observed in PCOS.
Literatur
1.
Zurück zum Zitat Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod. 2008;23(3):462–77.CrossRef Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod. 2008;23(3):462–77.CrossRef
2.
Zurück zum Zitat Heijnen EM, Eijkemans MJ, Hughes EG, Laven JS, Macklon NS, Fauser BC. A meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12(1):13–21.PubMedCrossRef Heijnen EM, Eijkemans MJ, Hughes EG, Laven JS, Macklon NS, Fauser BC. A meta-analysis of outcomes of conventional IVF in women with polycystic ovary syndrome. Hum Reprod Update. 2006;12(1):13–21.PubMedCrossRef
3.
Zurück zum Zitat The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.CrossRef The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41–7.CrossRef
4.
Zurück zum Zitat Polson DW, Wadsworth J, Adams J, Franks S. Polycystic ovaries: a common finding in normal women. Lancet. 1988;1(8590):870–2.PubMedCrossRef Polson DW, Wadsworth J, Adams J, Franks S. Polycystic ovaries: a common finding in normal women. Lancet. 1988;1(8590):870–2.PubMedCrossRef
5.
Zurück zum Zitat Clayton RN, Ogden V, Hodgekinson J, Worswick, Rodin DA, Dyer S, et al. How common are polycystic ovaries in normal women and what is their significance for the fertility of the population. Clin Endocrinol. 1992;37:127–34.CrossRef Clayton RN, Ogden V, Hodgekinson J, Worswick, Rodin DA, Dyer S, et al. How common are polycystic ovaries in normal women and what is their significance for the fertility of the population. Clin Endocrinol. 1992;37:127–34.CrossRef
6.
Zurück zum Zitat Farquhar CM, Birdsall M, Manning P, Mitchell JM. Transabdominal versus transvaginal ultrasound in the diagnosis of polycystic ovaries on ultrasound scanning in a population of randomly selected women. Ultrasound Obstet Gynecol. 1994;4:54–9.PubMedCrossRef Farquhar CM, Birdsall M, Manning P, Mitchell JM. Transabdominal versus transvaginal ultrasound in the diagnosis of polycystic ovaries on ultrasound scanning in a population of randomly selected women. Ultrasound Obstet Gynecol. 1994;4:54–9.PubMedCrossRef
7.
Zurück zum Zitat Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol. 1999;51:779–86.CrossRef Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol. 1999;51:779–86.CrossRef
8.
Zurück zum Zitat Lowe P, Kovacs G, Howlett D. Incidence of polycystic ovaries and polycystic ovary syndrome amongst women in Melbourne, Australia. Aust N Z J Obstet Gynaecol. 2005;45(1):17–9.PubMedCrossRef Lowe P, Kovacs G, Howlett D. Incidence of polycystic ovaries and polycystic ovary syndrome amongst women in Melbourne, Australia. Aust N Z J Obstet Gynaecol. 2005;45(1):17–9.PubMedCrossRef
9.
Zurück zum Zitat Engmann L, Maconochie N, Sladkevicius P, Bekir J, Campbell S, Tan SL. The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology. Hum Reprod. 1999;14(1):167–71.PubMedCrossRef Engmann L, Maconochie N, Sladkevicius P, Bekir J, Campbell S, Tan SL. The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology. Hum Reprod. 1999;14(1):167–71.PubMedCrossRef
10.
Zurück zum Zitat Esmailzadeh S, Faramarzi M, Jorsarai G. Comparison of in vitro fertilization outcome in women with and without sonographic evidence of polycystic ovarian morphology. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):67–70.PubMedCrossRef Esmailzadeh S, Faramarzi M, Jorsarai G. Comparison of in vitro fertilization outcome in women with and without sonographic evidence of polycystic ovarian morphology. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):67–70.PubMedCrossRef
11.
Zurück zum Zitat Esinler I, Bayar U, Bozdag G, Yarali H. Outcome of intracytoplasmic sperm injection in patients with polycystic ovary syndrome or isolated polycystic ovaries. Fertil Steril. 2005;84(4):932–7.PubMedCrossRef Esinler I, Bayar U, Bozdag G, Yarali H. Outcome of intracytoplasmic sperm injection in patients with polycystic ovary syndrome or isolated polycystic ovaries. Fertil Steril. 2005;84(4):932–7.PubMedCrossRef
12.
Zurück zum Zitat Wang QL, Song J, Chen SL, Luo C, Chen X, Li M, et al. Analysis of the clinical outcomes of IVF-ET treatment in infertile patients with polycystic ovary syndrome or polycystic ovaries. J South Med Univ. 2009;29(5):962–5. Wang QL, Song J, Chen SL, Luo C, Chen X, Li M, et al. Analysis of the clinical outcomes of IVF-ET treatment in infertile patients with polycystic ovary syndrome or polycystic ovaries. J South Med Univ. 2009;29(5):962–5.
13.
Zurück zum Zitat Kim YJ, Ku SY, Jee BC, Suh CS, Kim SH, Choi YM, et al. A comparative study on the outcomes of in vitro fertilization between women with polycystic ovary syndrome and those with sonographic polycystic ovary-only in GnRH antagonist cycles. Arch Gynecol Obstet. 2010;282(2):199–205.PubMedCrossRef Kim YJ, Ku SY, Jee BC, Suh CS, Kim SH, Choi YM, et al. A comparative study on the outcomes of in vitro fertilization between women with polycystic ovary syndrome and those with sonographic polycystic ovary-only in GnRH antagonist cycles. Arch Gynecol Obstet. 2010;282(2):199–205.PubMedCrossRef
14.
Zurück zum Zitat Swanton A, Storey L, McVeigh E, Child T. IVF outcome in women with PCOS, PCO and normal ovarian morphology. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):68–71.PubMedCrossRef Swanton A, Storey L, McVeigh E, Child T. IVF outcome in women with PCOS, PCO and normal ovarian morphology. Eur J Obstet Gynecol Reprod Biol. 2010;149(1):68–71.PubMedCrossRef
15.
Zurück zum Zitat Zhong YP, Ying Y, Wu HT, Zhou CQ, Xu YW, Wang Q, et al. Comparison of endocrine profile and in vitro fertilization outcome in patients with PCOS, ovulatory PCO, or normal ovaries. Int J Endocrinol. 2012; in press. Zhong YP, Ying Y, Wu HT, Zhou CQ, Xu YW, Wang Q, et al. Comparison of endocrine profile and in vitro fertilization outcome in patients with PCOS, ovulatory PCO, or normal ovaries. Int J Endocrinol. 2012; in press.
16.
Zurück zum Zitat Balen AH, Laven JSE, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update. 2003;9:505–14.PubMedCrossRef Balen AH, Laven JSE, Tan SL, Dewailly D. Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update. 2003;9:505–14.PubMedCrossRef
17.
Zurück zum Zitat Li HWR. LeeVCY, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Role of baseline antral follicle count and anti-mullerian hormone in prediction of cumulative live birth in the first in vitro fertilisation cycle: a retrospective cohort analysis. PLoS One. 2013;8(4):e61095.PubMedCentralPubMedCrossRef Li HWR. LeeVCY, Lau EYL, Yeung WSB, Ho PC, Ng EHY. Role of baseline antral follicle count and anti-mullerian hormone in prediction of cumulative live birth in the first in vitro fertilisation cycle: a retrospective cohort analysis. PLoS One. 2013;8(4):e61095.PubMedCentralPubMedCrossRef
18.
Zurück zum Zitat Royal College of Obstetricians and Gynaecologists. RCOG Green-top Guideline No. 5: The management of ovarian hyperstimulation syndrome. London: RCOG, 2006. Royal College of Obstetricians and Gynaecologists. RCOG Green-top Guideline No. 5: The management of ovarian hyperstimulation syndrome. London: RCOG, 2006.
19.
Zurück zum Zitat Yeung WSB, Li RHW, Cheung TM, Ng EHY, Lau EYL, Ho PC. Frozen-thawed embryo transfer cycles. Hong Kong Med J. 2009;15(6):420–6.PubMed Yeung WSB, Li RHW, Cheung TM, Ng EHY, Lau EYL, Ho PC. Frozen-thawed embryo transfer cycles. Hong Kong Med J. 2009;15(6):420–6.PubMed
20.
Zurück zum Zitat Wang JX, Davies MJ, Norman RJ. Polycystic ovarian syndrome and the risk of spontaneous abortion following assisted reproductive technology treatment. Hum Reprod. 2001;16(12):2606–9.PubMedCrossRef Wang JX, Davies MJ, Norman RJ. Polycystic ovarian syndrome and the risk of spontaneous abortion following assisted reproductive technology treatment. Hum Reprod. 2001;16(12):2606–9.PubMedCrossRef
21.
Zurück zum Zitat Weghofer A, Munne S, Chen S, Barad D, Gleicher N. Lack of association between polycystic ovary syndrome and embryonic aneuploidy. Fertil Steril. 2007;88:900–5.PubMedCrossRef Weghofer A, Munne S, Chen S, Barad D, Gleicher N. Lack of association between polycystic ovary syndrome and embryonic aneuploidy. Fertil Steril. 2007;88:900–5.PubMedCrossRef
22.
Zurück zum Zitat Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Hum Reprod Update. 2011;17(1):17–33.PubMedCrossRef Qiao J, Feng HL. Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence. Hum Reprod Update. 2011;17(1):17–33.PubMedCrossRef
23.
Zurück zum Zitat Catteau-Jonard S, Bancquart J, Poncelet E, Lefebvre-Maunoury C, Robin G, Dewailly D. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol. 2012;40:223–9.PubMedCrossRef Catteau-Jonard S, Bancquart J, Poncelet E, Lefebvre-Maunoury C, Robin G, Dewailly D. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol. 2012;40:223–9.PubMedCrossRef
Metadaten
Titel
Cumulative live-birth rate in women with polycystic ovary syndrome or isolated polycystic ovaries undergoing in-vitro fertilisation treatment
verfasst von
Hang Wun Raymond Li
Vivian Chi Yan Lee
Estella Yee Lan Lau
William Shu Biu Yeung
Pak Chung Ho
Ernest Hung Yu Ng
Publikationsdatum
01.02.2014
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 2/2014
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-013-0151-6

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