IVF outcomes in women with polycystic ovarian syndrome – are there increased risks?

This study investigated the outcomes of in vitro fertilization (IVF) pregnancies in women with polycystic ovarian syndrome (PCOS). 

They found that PCOS patients had a greater risk of complications after IVF.

Polycystic ovarian syndrome (PCOS) is a hormonal disorder that can lead to infertility. Women with PCOS may have problems ovulating. This makes it difficult to become pregnant. Many women with PCOS undergo in vitro fertilization (IVF). Controlled ovarian stimulation (COS) in the first step before IVF. COS drugs stimulate hormones to release of a mature egg. This can be harvested and used for IVF.

Some studies suggest that women with PCOS are at greater risk with IVF pregnancies. COS can lead to a dangerous condition called ovarian hyperstimulation syndrome (OHSS). Pregnancy-related outcomes (PROs) may also be different in PCOS patients undergoing IVF. However, the results from studies have been mixed. It is unclear of PCOS is associated with negative PROs. 

This study analyzed the results of 29 clinical studies with IVF. The patients in these studies had PCOS or other fertility issues (non-PCOS). The authors compared PROs across the studies. PROs included clinical pregnancy rate (CPR), live birth rate (LBR) and miscarriage rate (MCR). The rate of ectopic pregnancy (EPR; pregnancy in another part of the reproductive tract than the womb) and OHSS rate was also assessed. 

There was no difference in CPR between PCOS and non-PCOS patients. Increased LBR (29%), but also a higher MCR (41%) were noted in PCOS patients. OHSS rates were 4.96 times higher in PCOS patients.

The risk of pregnancy diabetes was 2.65 times greater in PCOS patients. The risk of pregnancy-induced hypertension (high blood pressure) was also 2.06 times greater in PCOS patients. Babies born to women with PCOS were 2.1 times more likely to be large for their pregnancy age. 

The authors concluded that patients with PCOS had a greater risk of complications after IVF.

There was variability in the study designs and protocols. Some patient data were not available for analysis. There may be unreported factors affecting the PROs. More investigation is needed. 

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