Polycystic ovarian syndrome (PCOS) is considered one of the
most common endocrine disorders of women of reproductive age. It is
characterized by chronic anovulation, signs of hyperandrogenism,
polycystic appearance of ovaries and subfertility or sterility. Although
polycystic ovaries are a common finding in infertile women, the exact
incidence of these patients included in the in vitro fertilization
program is not known.
The aim of this study was to assess the effect of PCOS on the course
and the outcome of in vitro fertilization; compare the characteristics of
ovarian response and compare the clinical pregnancy and miscarriage
rates in women with PCOS to those in women with tubal factor sterility;
examine which ovarian stimulation protocol in patients with PCOS has a
higher success rate and a lower risk of the occurrence of Ovarian
Hyperstimulation Syndrome (OHSS); examine the effect of age, body
mass index, levels of Anti-Mullerian hormone and the use of metformin
on in vitro fertili...zation (IVF) outcomes in patients with PCOS.
The research was conducted as a prospective comparative study.
The study included 123 patients with PCOS and 94 patients
participating IVF program due to tubal sterility. The patients were
treated by a long GnRH agonist protocol, a short GnRH agonist
protocol or a flexible GnRH antagonist protocol.
The patients with PCOS have a higher number of the oocytes
retrieved and a lower fertilization rate. Clinical pregnancy and
miscarriage rates did not differ significantly between the two groups,
while OHSS was present only in the group of patients with PCOS. The
length of stimulation of patients with PCOS was shorter in the antagonist
group, whereas the total number of aspirated oocytes was statistically
significantly higher in the agonist group. Significantly higher number of
the obtained embryos as well as a higher number of best quality embryos
in the agonist group did not affect the clinical pregnancy rate.
We have concluded that patients with PCOS achieve clinical
pregnancy rates similar to those of women with tubal factor infertility.
The antagonist protocol has clinical pregnancy rate comparable to that
of the agonist protocol. Although there is no statistically significant
difference in the incidence of OHSS, a less frequent occurrence of
this serious complication has been noticed in the antagonist protocol.
