Association between the Different Phenotypes of Polycystic Ovary Syndrome and the Outcome in in Vitro Fertilization at Human Reproductive Center Paul et Chantal Biya-Yaoundé
Background:In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) represents the final
step in the management of Polycystic Ovarian Syndrome (PCOS). Our objective was
to study the association between PCOS phenotypes and IVF/ICSI results in women
admitted to Gynaecological Endoscopic Surgery and Human Reproductive Teaching
Hospital (CHRACERH). Material and Method: We carried out a cohort study
with historical-prospective data collection over a period of seven years
(January 2016 to March 2023) at Chracerh. PCOS patients were subdivided into 4 subgroups A, B, C and D. Results: We recruited 128 patients including 64 PCOS patients divided into four
phenotypes and 64 non-PCOS patients constituting the control group. Phenotype D
without hyperandrogenism had used the lowest dose of gonadotropins, i.e. 1939.7 ± 454.3 IU, and had produced
a greater quantity of estradiol on the day ovulation was triggered (6529.8 ± 4324.8
ng/ml). The average number of punctured follicles and mature oocytes were
higher in the phenotype D group. Ovarian hyperstimulation syndrome (OHSS)
occurred mainly in phenotype D (3/35), with an estimated prevalence of 2.3%.
The fertilization rate seemed lower in the hyperandrogenic phenotypes A, B, C
compared to the group without hyperandrogenism
without significant difference (p = 0.461). The biological pregnancy rate and
live birth rate were comparable between the different groups. Conclusion: Phenotype
D used less dose of gonadotropins. Biological pregnancy and live birth rates
were comparable between the different phenotypes.
References
[1]
Lizneva, D., Suturina, L., Walker, W., Brakta, S., Gavrilova-Jordan, L. and Azziz, R. (2016) Criteria, Prevalence, and Phenotypes of Polycystic Ovary Syndrome. Fertility and Sterility, 106, 6-15. https://doi.org/10.1016/j.fertnstert.2016.05.003
[2]
Azziz, R., Woods, K.S., Reyna, R., Key, T.J., Knochenhauer, E.S. and Yildiz, B.O. (2004) The Prevalence and Features of the Polycystic Ovary Syndrome in an Unselected Population. The Journal of Clinical Endocrinology & Metabolism, 89, 2745-2749.
https://doi.org/10.1210/jc.2003-032046
[3]
Wang, Q., Wang, H., Li, P., Li, X., Wang, Z., Yan, L., et al. (2022) Association of Polycystic Ovary Syndrome Phenotypes with Adverse Pregnancy Outcomes after In-Vitro Fertilization/Intracytoplasmic Sperm Injection. Front Endocrinol, 13.
https://doi.org/10.3389/fendo.2022.889029
https://www.frontiersin.org/articles/10.3389/fendo.2022.889029
[4]
Giampaolino, P., Morra, I., Della Corte, L., Sparice, S., Di Carlo, C., Nappi, C., et al. (2017) Serum Anti-Mullerian Hormone Levels after Ovarian Drilling for the Second-Line Treatment of Polycystic Ovary Syndrome: A Pilot-Randomized Study Comparing Laparoscopy and Transvaginal Hydrolaparoscopy. Gynecological Endocrinology, 33, 26-29. https://doi.org/10.1080/09513590.2016.1188280
[5]
Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2008) Consensus on Infertility Treatment Related to Polycystic Ovary Syndrome. Fertility and Sterility, 89, 505-522. https://doi.org/10.1016/j.fertnstert.2007.09.041
[6]
Giampaolino, P., De Rosa, N., Della Corte, L., Morra, I., Mercorio, A., Nappi, C., et al. (2018) Operative Transvaginal Hydrolaparoscopy Improve Ovulation Rate after Clomiphene Failure in Polycystic Ovary Syndrome. Gynecol Endocrinol Off J Int Soc., 34, 32-35. https://doi.org/10.1080/09513590.2017.1412429
[7]
Cela, V., Obino, M.E.R., Alberga, Y., Pinelli, S., Sergiampietri, C., Casarosa, E., et al. (2018) Ovarian Response to Controlled Ovarian Stimulation in Women with Different Polycystic Ovary Syndrome Phenotypes. Gynecological Endocrinology, 34, 518-523. https://doi.org/10.1080/09513590.2017.1323204
[8]
Ramezanali, F., Ashrafi, M., Mandana, H., Arabipoor, A., Jalali, S. and Moini, A. (2016) Assisted Reproductive Outcomes in Women with Different Polycystic Ovary Syndrome Phenotypes: The Predictive Value of Anti-Mullerian Hormone. Reproductive BioMedicine, 32, 503-512. https://doi.org/10.1016/j.rbmo.2016.01.010
[9]
Brodin, T., Bergh, T., Berglund, L., Hadziosmanovic, N. and Holte, J. (2009) High Basal LH Levels in Combination with Low Basal FSH Levels Are Associated with High Success Rates at Assisted Reproduction. Human Reproduction, 24, 2755-2759.
https://doi.org/10.1093/humrep/dep254
[10]
Mackens, S., Pareyn, S., Drakopoulos, P., Deckers, T., Mostinckx, L., Blockeel, C., et al. (2020) Outcome of In-Vitro Oocyte Maturation in Patients with PCOS: Does Phenotype Have an Impact? Human Reproduction, 35, 2272-2279.
https://doi.org/10.1093/humrep/deaa190
[11]
Le Gouez, A., Naudin, B., Grynberg, M. and Mercier, F.J. (2011) Le syndrome hyperstimulation ovarienne. Annales Françaises d’Anesthésie et de Réanimation, 30, 353-362. https://doi.org/10.1016/j.annfar.2010.11.026
[12]
Madill, J.J., Mullen, N.B. and Harrison, B.P. (2008) Ovarian Hyperstimulation Syndrome: A Potentially Fatal Complication of Early Pregnancy. Journal of Emergency Medicine, 35, 283-286. https://doi.org/10.1016/j.jemermed.2007.11.074
[13]
Patel, S.S. and Carr, B.R. (2008) Oocyte Quality in Adult Polycystic Ovary Syndrome. Seminars in Reproductive Medicine, 26, 196-203.
https://doi.org/10.1055/s-2008-1042958
[14]
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group (2004) Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome. Fertility and Sterility, 81, 19-25.
https://doi.org/10.1016/j.fertnstert.2003.10.004
[15]
Wood, J.R., Ho, C.K., Nelson-Degrave, V.L., McAllister, J.M. and Strauss III, J.F. (2004) The Molecular Signature of Polycystic Ovary Syndrome (PCOS) Theca Cells Defined by Gene Expression Profiling. Journal of Reproductive Immunology, 63, 51-60. https://doi.org/10.1016/j.jri.2004.01.010
