Improved implantation and ongoing pregnancy rates after single embryo transfer with an optimized protocol for in vitro oocyte maturation in women with polycystic ovaries and PCOS

Capsule:
Improved implantation and ongoing pregnancy rates after single-embryo transfer in women with polycystic ovaries or polycystic ovary syndrome result from a modified in vitro maturation protocol.

Authors:
Stephen M. Junk, Ph.D. and Doreen Yeap, M.B.B.S., F.R.A.N.Z.C.O.G.

Volume 98, Issue 4, Pages 888-892, October 2012

Abstract:

Objective:
To describe an optimized protocol for oocyte in vitro maturation (IVM) that achieves improved implantation and ongoing pregnancy rates in women with polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS).

Design:
Prospective cohort study.

Setting:
Hospital fertility unit.

Patients:
Women with PCO and PCOS undergoing treatment for infertility.

Interventions:
Follicle-stimulating hormone (FSH) priming, IVM, blastocyst culture, hormone replacement therapy.

Main Outcome Measure:
Clinical pregnancy rates

Results:
Our optimized IVM protocol achieves implantation and ongoing pregnancy rates comparable to in vitro fertilization. From 66 oocyte collections, 844 oocytes were collected (12.8 oocytes/cycle), 588 oocytes matured after IVM (69.7% maturation rate), 420 oocytes fertilized after ICSI (71.4% fertilization rate), and 175 blastocyst-stage embryos resulted (41.7% blastocyst-development rate). Of these, 62 blastocyst-stage embryos were transferred as single embryos, resulting in 29 clinical pregnancies (43.9%/oocyte collection, 46.7%/embryo transfer) and 28 live births (42.4%/oocyte collection, 45.2%/embryo transfer).

Conclusion:
In women with PCO or PCOS, improved implantation, clinical pregnancy, and live-birth rates can be achieved after single-embryo transfer by the use of an optimized IVM protocol.

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