The Outcome Of In Vitro Fertilization In Women With Polycystic Ovarian Syndrome

Objective:To study the outcome of In vitro fertilization/intra cytoplasmic sperm injection and embryotransfer in infertile patients with polycystic ovarian syndrome and their effects with increasingage and weight.Materials and Methods:This Retrospective study was conducted in Department of Reproduction, Union hospital,Tongji Medical Collge, Huazhong University of Science and Technology (HUST) from January2008to December2010. The study consists of108patients with PCOS (without any othercause of infertility) who underwent IVF/ICSI-ET treatment in our centre. The control groupconsists of120patients with only tubal block infertility. Our study was based on the first cycleof IVF/ICSI-ET in two groups. All the patients had treated with the down regulation andovarian stimulation with long protocol. The dosage of gonadotrophin, clinical pregnancy rate,live birth rate, spontaneous abortion rate, ovarian hyperstimulation syndrome (OHSS) rateand effect of pregnancy with increasing age and weight were analyzed and comparedbetween the two groups. ResultsThe result of this research showed that there are significant difference in overall pregnancyrate between PCOS and tubal factor groups (26.85%(29/108) and43.33%(52/120) p<0.0094)respectively. The pregnancy rate with different treatment modalities are different in bothgroups. The pregnancy rate with IVF-ET is statistically significant (PCOS35.53%(21/76) andTubal factor45.84%(44/96, p<0.0145) but the ICSI-ET treatment is not significant. Live birthrate was similar in both groups. Complications were seen in the form of OHSS, abortion andectopic pregnancy. The rate of abortion and ectopic pregnancy were statistically notsignificant while as, the rate of OHSS is much higher in PCOS than tubal factor group (PCOS38.89%and Tubal factor1.6%p<0.0001). In a defined time cycle, the number of rFSHampoules was higher for the tubal factor group (18.42±7.83versus14.49±3.76, p <0.0001) butPCOS required more number of ampoules of HMG than tubal factor group (44.64±18.11vs8.86±9.26p<0.026). The duration of ovarian stimulation days are more in tubal factor thanPCOS group (10.94±2.50vs9.30±1.06p<0.0001). There are significantly more oocytes perretrieval were obtained in PCOS patients compared with controls (18.48±14.08versus10.46±7.04, p<0.0001). Failure of oocyte retrieval and failure of fertilization rate werestatistically not significant.ConclusionThe result of this study showed that IVF-ET can be a successful treatment in PCOS patientsresistant to other usual treatments and the hormonal disturbance of PCOS patients had nosignificant effect on IVF/ICSI-ET outcome in comparison to patients with tubal factor infertility.Although the baby take-home rate was similar among women with PCOS and control group,but the other outcomes of consecutive cycles were not equal. Cumulative data give morerealistic information.