M Kdous1, A Chaker, A Zhioua, F Zhioua. 1. Service de gynécologie obstétrique et de médecine de la reproduction, centre de PMA, hôpital Aziza-Othmana de Tunis, 1008 La Kasba, Tunis, Tunisie. kdousm@excite.com
Abstract
OBJECTIVE: To compare the oocyte and embryo quality and outcomes in polycystic ovary syndrome (PCOS) patients and normo-ovulatory women undergoing intracytoplasmic sperm injection (ICSI) cycles. MATERIALS AND METHODS: We studied retrospectively 100 controlled ovarian stimulation cycles for ICSI in women with PCOS and 200 cycles in normo-ovulatory women. Every PCOS woman was paired according to age with two normo-ovulatory woman undergoing ICSI during the same study period. A long protocol of gonadotrophin releasing hormone (GNRH) agonist was carried out in all patients. The main outcome measures evaluated were: cancellation of the cycles, number of aspirated follicles, oocyte maturity, fertilization rate, embryo quality pregnancy and implantation rates, clinical abortion rate, multiple pregnancy rate and the "take-home baby" rate. Khi(2) test and Student t test were used for differences between normo-ovulatory and PCOS patients and the limit of significance was set at p<0,05. RESULTS: ICSI was performed for male infertility in most cases (79% in PCOS group vs 79,5%; NS). There was no significant difference in term of cancellation rate (5,5% in PCOS group vs 5%; NS). The mean number of follicles was higher in patients with PCOS (18,1+/-8,5 vs 9,4+/-5,5; p<0,001). Oocyte mature rate (67% vs 52%; p<0,001), fertilization rate (75% vs 63,7%; p<0,001) and grade 1 embryo rate (69% vs 53%; p<0,001) were significantly higher in PCOS group. The mean number of transferred embryos was similar in the two groups (2,46+/-0,5 vs 2,54+/-1,01; NS). Implantation rate (16,6% vs 12,1%; NS), clinical pregnancy rate per transfer (31,5% vs 24%; NS) and Live birth rate (22% vs 20%; NS) did not differ statistically in the two groups. Twin and triplet pregnancies rates were similar in the two groups (20% vs 16,7%; NS and 6,6% vs 7,1% ; NS respectively). Miscarriage rate was higher in PCOS group but this did not reach the statistical significance (26,6% vs 16,6%; NS). CONCLUSION: PCOS patients showed better global oocyte and embryo quality. However, pregnancy and live birth rates were similar in the two groups when number and quality of transferred embryos are equivalent.
OBJECTIVE: To compare the oocyte and embryo quality and outcomes in polycystic ovary syndrome (PCOS) patients and normo-ovulatory women undergoing intracytoplasmic sperm injection (ICSI) cycles. MATERIALS AND METHODS: We studied retrospectively 100 controlled ovarian stimulation cycles for ICSI in women with PCOS and 200 cycles in normo-ovulatory women. Every PCOSwoman was paired according to age with two normo-ovulatory woman undergoing ICSI during the same study period. A long protocol of gonadotrophin releasing hormone (GNRH) agonist was carried out in all patients. The main outcome measures evaluated were: cancellation of the cycles, number of aspirated follicles, oocyte maturity, fertilization rate, embryo quality pregnancy and implantation rates, clinical abortion rate, multiple pregnancy rate and the "take-home baby" rate. Khi(2) test and Student t test were used for differences between normo-ovulatory and PCOSpatients and the limit of significance was set at p<0,05. RESULTS: ICSI was performed for male infertility in most cases (79% in PCOS group vs 79,5%; NS). There was no significant difference in term of cancellation rate (5,5% in PCOS group vs 5%; NS). The mean number of follicles was higher in patients with PCOS (18,1+/-8,5 vs 9,4+/-5,5; p<0,001). Oocyte mature rate (67% vs 52%; p<0,001), fertilization rate (75% vs 63,7%; p<0,001) and grade 1 embryo rate (69% vs 53%; p<0,001) were significantly higher in PCOS group. The mean number of transferred embryos was similar in the two groups (2,46+/-0,5 vs 2,54+/-1,01; NS). Implantation rate (16,6% vs 12,1%; NS), clinical pregnancy rate per transfer (31,5% vs 24%; NS) and Live birth rate (22% vs 20%; NS) did not differ statistically in the two groups. Twin and triplet pregnancies rates were similar in the two groups (20% vs 16,7%; NS and 6,6% vs 7,1% ; NS respectively). Miscarriage rate was higher in PCOS group but this did not reach the statistical significance (26,6% vs 16,6%; NS). CONCLUSION:PCOSpatients showed better global oocyte and embryo quality. However, pregnancy and live birth rates were similar in the two groups when number and quality of transferred embryos are equivalent.