Age and infertility treatment – do women with polycystic ovarian syndrome have an advantage?

This study investigated the effect of age on infertility treatment in women with polycystic ovarian syndrome (PCOS). They found that age-related decline (ARD) in fertility treatment outcomes was slower in women with PCOS. 

Polycystic ovarian syndrome (PCOS) is caused by cysts on the ovaries. Women with PCOS have abnormal hormone levels. Many women do not ovulate normally. As a result, PCOS is associated with reduced fertility. Age is a key factor in infertility. After the age of 35, a woman’s fertility decreases. Some studies suggest that age-related decline (ARD) in fertility is slower in women with PCOS. 

PCOS symptoms tend to improve after the age of 40. Hormone levels begin to rebalance. Ovulation may restart. These women will have a better ovarian reserve than women without PCOS. This may make it easier to become pregnant. However, the effect of age on other fertility outcomes is not clear. It is unclear if the effect of ARD on fertility treatment outcomes is different in women with PCOS than in those without PCOS. 

This study included 22,098 women undergoing in vitro fertilization (IVF). 3,502 women had PCOS. The other 18,596 had infertility due to tubal factors. All women underwent IVF and frozen embryo transfer (FET). Women were categorized according to cause of infertility (PCOS or non-PCOS) and age. Fertility outcomes were analyzed. These included the cumulative live birth rate (CLBR). Clinical pregnancy rate (CPR) and implantation rate (IR) were also compared. 

Patients over 40 with PCOS had higher IR (27.8%) compared to the non-PCOS group (15.7%). The CPR was also higher in PCOS patients over 40 (51.4% vs 26.1%). The CLBR was higher in PCOS patients over 40 (50% vs. 21.5%).

ARD in IR, CPR, and CLBR were slower in PCOS patients. The fertility outcomes for patients with PCOS over 40 were similar to those of women with PCOS  between the ages of 35 and 40. High body mass index (BMI) was associated with lower CLBR in PCOS women under 35. Age and the number of eggs retrieved were associated with CLBR in PCOS women over 35. 

The authors concluded that ARD in infertility treatment outcomes was slower in women with PCOS compared to those without PCOS.

This was a retrospective study. This means it was based on medical records data. Information might have been missing that might have influenced the results. The number of older PCOS patients in the study was relatively low. More studies are needed.  

If you have any concerns regarding infertility please consult with your physician.