In-vitro maturation versus IVF with GnRH antagonist for women with polycystic ovary syndrome: treatment outcome and rates of ovarian hyperstimulation syndrome

Reprod Biomed Online. 2014 Nov;29(5):545-51. doi: 10.1016/j.rbmo.2014.07.019. Epub 2014 Aug 12.

Abstract

In-vitro maturation (IVM) treatment has gained popularity for decreasing the incidence of ovarian hyperstimulation syndrome (OHSS) by eliminating or minimizing the use of gonadotrophins in women with polycystic ovary syndrome (PCOS). Studies have shown that IVF with GnRH-antagonist protocol is associated with a lower incidence of OHSS. Data comparing the relative success of these two treatments is, however, lacking. Treatment outcome and rates of OHSS were compared in patients with PCOS who underwent assisted conception with either IVM or IVF with GnRH-antagonist protocol between 2006 and 2011. The number of oocytes retrieved was higher in the IVM group, whereas the number of mature oocytes, fertilization rate and number of embryos cleaved were comparable. The implantation rate was higher in the IVF group. The clinical pregnancy rates per embryo transfer were not statistically different (IVF: 45.8% versus IVM: 32.4%). The live-birth rate was higher in the IVF group (IVF: 40.7% versus IVM: 23.5%; P = 0.04). Five women developed moderate or severe OHSS in the IVF group, whereas none did in the IVM group. Both IVM and IVF with GnRH-antagonist protocol seem to be effective treatment regimens in women with PCOS, although IVM is associated with a lower risk of OHSS.

Keywords: GnRH antagonist; in-vitro-fertilization (IVF); in-vitro-maturation (IVM); ovarian hysperstimulation syndrome (OHSS); polycystic ovary syndrome (PCOS).

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Embryo Implantation
  • Embryo Transfer / adverse effects
  • Female
  • Fertilization in Vitro / adverse effects*
  • Gonadotropin-Releasing Hormone / antagonists & inhibitors*
  • Hormone Antagonists / therapeutic use
  • Humans
  • Incidence
  • Infertility, Female / therapy
  • Ovarian Hyperstimulation Syndrome / epidemiology
  • Ovarian Hyperstimulation Syndrome / prevention & control*
  • Ovulation Induction
  • Polycystic Ovary Syndrome / drug therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Retrospective Studies
  • Sperm Injections, Intracytoplasmic / adverse effects
  • Treatment Outcome

Substances

  • Hormone Antagonists
  • Gonadotropin-Releasing Hormone