In a nutshell
This study investigated fertility outcomes in women with polycystic ovarian syndrome (PCOS) who had a single ideal fresh embryo transfer. They found that the live birth rate (LBR) was lower in women with PCOS compared to control women.
Polycystic ovarian syndrome (PCOS) is a disorder that can cause infertility. Women with PCOS may not ovulate normally. They have high levels of androgens (male sex hormones such as testosterone). Assisted reproduction (AR) is used to treat infertility. In vitro fertilization (IVF) is an AR technique commonly used in PCOS patients. Controlled ovarian stimulation (COS) is used to retrieve eggs for IVF. COS can be difficult in women with PCOS.
Some studies suggest the embryo quality (EQ) from COS is lower in PCOS patients. This could be associated with poorer fertility outcomes. There is some evidence that miscarriage rates are higher in PCOS women after COS/IVF. Evidence suggests this could because of high androgen levels in the uterus. This can lead to pregnancy loss. It is unclear if PCOS affects other fertility outcomes in women undergoing COS/IVF.
Methods & findings
This study included 71 women with PCOS. 272 women who ovulated normally were also included as controls. These women did not undergo COS. All women underwent IVF with a single ideal fresh embryo transfer. The authors compared fertility outcomes between the groups. The live birth rate (LBR) was the main outcome. The analysis was adjusted to take account of factors that are known to affect the LBR. These included female age and COS protocol.
Women with PCOS were more likely to be younger and have higher testosterone levels. Embryo quality was similar in both groups. A basic analysis suggested the LBR was similar in both groups. However, when taking into account differences between groups such as women's age, the total dose of COS drugs used, and the number of previous pregnancies and live births, the LBR was significantly lower in women with PCOS.
The bottom line
The authors concluded that the LBR was lower in women with PCOS. The authors suggest that high testosterone levels may be involved in decreasing the chance of a live birth in these women.
The fine print
This study was based on medical records. There could be unknown factors affecting the results of this study. EQ was one of the inclusion criteria in this study. This means that the effect of PCOS on IVF outcomes could be different in lower quality embryos.
If you have any concerns regarding infertility please discuss it with your physician.
Published By :
Archives of Gynecology and Obstetrics
Jul 15, 2020