Abstract
Background
With the expanding utilization of prolonged protocol, switching from in vitro fertilization to in vitro maturation (IVF/M) was a choice to prevent ovarian hyperstimulation syndrome and to avoid cycle cancellation. Our aim was to explore the feasibility of IVF/M in polycystic ovarian syndrome (PCOS) patients with unexpected poor ovarian response (UPOR) underwent prolonged protocol by comparing with IVF.
Methods
A retrospective analysis was performed on PCOS patients who were treated with prolonged protocol from June 2016 to December 2022. A total of 444 patients were diagnosed with unexpected poor ovarian response during ovarian stimulation. 156 patients performed IVF/M and 288 patients were treated with IVF. Laboratorial and clinical outcomes were analyzed and compared in two Groups.
Results
The Positive β-hCG rate (57.9%), clinical pregnancy rate (52.6%), live birth rate (38.9%) in fresh embryo transfer and cumulative live birth rate (35.3%) in IVF/M Group were lower than those in IVF Group (76.1%,66.8%,53.3%, 67.7%, respectively;all P < 0.05). The number of oocytes retrieved, mature oocytes, 2 pronuclear zygotes, embryos on day3, available blastocysts and high-quality blastocysts in IVF/M Group were less than those in IVF Group (P < 0.001). IVF/M Group gained no case of ovarian hyperstimulation syndrome (OHSS) while 59 (20.5%) patients cancelled fresh embryo transfer for OHSS and 23 (8.0%) of them were moderate to severe OHSS in IVF Group (P < 0.05). The pregnancy and neonatal complications were comparable between two groups. No dominant risk factor was found for non-live birth in fresh embryo transfer cycle. The only independent risk factor for non-live birth in cumulative cycles was IVF/M protocol. (4.58, 95%CI:2.94–7.13, P < 0.001).
Conclusion
IVF/M was a complement feasible choice for PCOS with UPOR who underwent prolonged protocol. Though with a lower live birth rate compared with IVF, almost one third couples still could achieve live birth and avoid neither cycle cancellation nor OHSS.