OBJECTIVETo investigate the association of the clinical characteristics and the outcome of in vitro fertilization and embryo transfer (IVF-ET) in infertile women with polycystic ovarian syndrome (PCOS) of different subtypes.

METHODSA total of 189 infertile women with PCOS undergoing IVF-ET were enrolled in this study. According to Rotterdam PCOS diagnosis criteria, the patients were classified into 3 PCOS subtypes, namely type I with PCO ultrasonography and oligo-ovulation/anovulation and hyperandrogenism (54 women, for whom 58 fresh IVF-ET cycles were performed); type II with PCO ultrasonography and oligo-ovulation/anovulation (117 women with 126 cycles); type III with PCO ultrasonography and hyperandrogenism (18 women with 18 cycles). The number of retrieved oocytes, fertilization rate, implantation rate, clinical pregnancy rate, spontaneous abortion rates and incidence of ovarian hyperstimulation syndrome (OHSS) were compared between the 3 groups.

RESULTSExcept for the baseline serum T concentration in the early phase of menstrual cycle, which was significantly higher in groups I and III than in group II, no significant difference was found in the clinical characteristics between the 3 groups (P>0.05). Group I had the highest initial Gn dose, and the oocyte retrieval rates were significantly lower in groups I and III (P<0.05). The patients in group I had lower implantation rate and the clinical, on-going and cumulative pregnancy rates than groups II and III, but the differences were not statistically significant; the embryo early loss rate and spontaneous abortion rate appeared to be higher in groups I and III (P>0.05). Significantly elevated incidence of OHSS were noted in groups I and III (P<0.05).

CONCLUSIONThe women with different PCOS subtypes according to the Rotterdam criteria all have similar IVF-ET outcomes, and the increased embryo loss rate and spontaneous abortion rate in groups I and III might be associated with excessive androgen that disturbs oocyte and embryo development.