ABSTRACT
OBJECTIVE: The purpose of this study was to identify useful clinical factors for the identification of patients with polycystic ovary syndrome (PCOS) who would benefit from in vitro maturation (IVM) treatment without exhibiting compromised pregnancy outcomes. METHODS: A retrospective cohort study was performed of 186 consecutive patients with PCOS who underwent human chorionic gonadotropin-primed IVM treatment between March 2010 and March 2014. Only the first IVM cycle of each patient was included in this study. A retrospective case-control study was subsequently conducted to compare pregnancy outcomes between IVM and conventional in vitro fertilization (IVF) cycles. RESULTS: Through logistic regression analyses, we arrived at the novel finding that serum anti-Müllerian hormone (AMH) levels and the number of fertilized oocytes in IVM were independent predictive factors for live birth with unstandardized coefficients of 0.078 (95% confidence interval [CI], 1.005-1.164; p=0.037) and 0.113 (95% CI, 1.038-1.208; p=0.003), respectively. Furthermore, these two parameters were able to discriminate patients who experienced live births from non-pregnant IVM patients using cut-off levels of 8.5 ng/mL and five fertilized oocytes, respectively. A subsequent retrospective case-control study of patients with PCOS who had serum AMH levels ≥8.5 ng/mL showed that IVM had pregnancy outcomes comparable to conventional IVF, and that no cases of ovarian hyperstimulation syndrome were observed. CONCLUSION: Serum AMH levels are a useful factor for predicting pregnancy outcomes in PCOS patients before the beginning of an IVM cycle. IVM may be an alternative to conventional IVF for PCOS patients if the patients are properly selected according to predictive factors such as serum AMH levels.
Subject(s)
Female , Humans , Pregnancy , Case-Control Studies , Chorion , Cohort Studies , Fertilization in Vitro , In Vitro Oocyte Maturation Techniques , In Vitro Techniques , Live Birth , Logistic Models , Oocytes , Ovarian Hyperstimulation Syndrome , Polycystic Ovary Syndrome , Pregnancy Outcome , Pregnancy Rate , Retrospective StudiesABSTRACT
Objetivos: Determinar la efectividad de la maduración in vitro (MIV) de ovocitos, como método de reproducción asistida. Diseño: Estudio descriptivo. Institución: Centro de Fertilidad y Ginecología del Sur (CFGS), Cusco, Perú. Participantes: Mujeres con diagnóstico de infertilidad. Intervenciones: Fueron ocho mujeres en las que se realizó MIV de ovocitos, seguido de ICSI, cultivo y vitrificación de embriones. Posteriormente, se preparó el endometrio de las pacientes y se realizó descongelación y transferencia de embriones. Principales medidas de resultados: Tasas de maduración de ovocitos, de fecundación, de embarazo clínico y de implantación. Resultados: La tasa de maduración de ovocitos fue 82,1%, de fecundación 95,7%, de embarazo clínico 62,5% y de implantación 29,4%. Conclusión: La MIV de ovocitos es una alternativa efectiva en reproducción asistida.
Objectives: To determine the effectiveness of in vitro maturation (IVM) of oocytes in assisted reproduction. Design: Descriptive study. Setting: Centro de Fertilidad y Ginecología del Sur (CFGS), Cusco, Peru. Participants: Women with diagnosis of infertility. Interventions: In eight women we performed IVM of oocytes, followed by ICSI, culture and vitrification of embryos. Thereafter, patients endometrium was prepared and the embryos were thawed and transferred. Main outcome measures: Maturation of oocytes, fertilization, clinical pregnancy and implantation rates. Results: Maturation of oocytes rate was 82.1%, fertilization rate 95.7%, clinical pregnancy 62.5% and implantation rate 29.4%. Conclusion: IVM of oocytes is an effective alternative in assisted reproduction.