Back to Search Start Over

Rescue In Vitro Maturation in Polycystic Ovarian Syndrome Patients Undergoing In Vitro Fertilization Treatment who Overrespond or Underrespond to Ovarian Stimulation: Is It A Viable Option? A Case Series Study.

Authors :
Fatum M
Bergeron ME
Ross C
Ding A
Bhevan A
Turner K
Child T
Source :
International journal of fertility & sterility [Int J Fertil Steril] 2020 Jul; Vol. 14 (2), pp. 137-142. Date of Electronic Publication: 2020 Jul 15.
Publication Year :
2020

Abstract

Background: This study intends to present the role of rescue in vitro maturation (IVM) in polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization (IVF) treatment who have inappropriate responses to ovarian stimulation.<br />Materials and Methods: This was a retrospective case series study of five PCOS patients undergoing IVF treatment considered for cycle cancellation due to increased risk of ovarian hyperstimulation syndrome (OHSS) as group A or poor response to ovarian stimulation as group B. Patients in group A had high oestradiol levels and recruitment of high numbers of small/intermediate sized follicles that did not meet the criteria for human chorionic gonadotropin (hCG) triggering. Patients in group B responded inadequately to hormonal stimulation despite high gonadotropin dosage. Treatment was changed to rescue IVM cycles after the patients provided consent.<br />Results: In group A, three IVF patients deemed to have high chances of developing OHSS as evidenced by high oestradiol levels were converted to IVM. A total of the 58/68 oocytes retrieved were mature or matured in vitro . There were 26 cleaving embryos obtained. Two patients had live births and one patient suffered a miscarriage. In group B, rescue IVM was implemented in two patients due to poor ovarian response (POR). A total of 22/26 oocytes retrieved were mature or matured in vitro . There were 13 cleaving embryos obtained. One patient had a live birth, whilst the other suffered a miscarriage.<br />Conclusion: Rescue IVM could be a viable option in PCOS patients undergoing IVF treatment who are unable to safely meet the criteria for hCG triggering due to overresponse to ovarian stimulation or ovarian resistance to high doses of stimulation. Conversion to IVM can still result in reasonable oocyte retrieval and lead to clinical pregnancy and live births without the risks of OHSS.<br />Competing Interests: The authors declare no conflicts of interest.<br /> (Copyright© by Royan Institute. All rights reserved.)

Details

Language :
English
ISSN :
2008-076X
Volume :
14
Issue :
2
Database :
MEDLINE
Journal :
International journal of fertility & sterility
Publication Type :
Academic Journal
Accession number :
32681626
Full Text :
https://doi.org/10.22074/ijfs.2020.6025