Relationship between the number of oocytes retrieved and in vitro maturation outcomes in patients with polycystic ovary syndrome undergoing natural cycles
10.3760/cma.j.cn101441-20210306-00102
- VernacularTitle:多囊卵巢综合征患者自然周期获卵数的影响因素及其与体外成熟结局的相关性分析
- Author:
Tao LIU
1
;
Dongming LIU
1
;
Xueling SONG
1
;
Xiaoying ZHENG
1
;
Caihong MA
1
;
Rong LI
1
;
Jie YAN
1
;
Jie QIAO
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心，北京100191
- Publication Type:Journal Article
- Keywords:
Polycystic ovary syndrome;
Number of oocytes retrieved;
Natural cycle;
Clinical pregnancy rate;
Live birth rate
- From:
Chinese Journal of Reproduction and Contraception
2022;42(8):782-790
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the factors that influence the number of oocytes retrieved of patients with polycystic ovary syndrome (PCOS) undergoing unstimulated natural cycles and the association between the number of oocytes retrieved and in vitro maturation (IVM) outcomes. Methods:This retrospective cohort study reviewed clinical data of 586 patients with PCOS undergoing unstimulated natural cycle at Reproductive Medicine Center, Department of Obstetrics and Gynecology of Peking University Third Hospital from 2006 January 1 to 2019 December 31. All patients were divided into three groups according to the number of oocytes retrieved (0-8, 9-19, ≥20). Basic information, basal endocrine hormones, oocyte and embryo development index and clinical outcomes were compared among the three groups.Results:Luteinizing hormone (LH)/follicle-stimulating hormone (FSH) [1.00(0.61,1.76), 1.41 (0.86, 1.96), 1.62(0.96, 2.14)], testosterone [1.07 (0.69, 1.91) nmol/L, 1.28 (0.77, 1.95) nmol/L, 1.67 (1.03, 2.75) nmol/L] and antral follicle count (AFC) [24 (19,24), 24 (24, 30), 30 (24, 40)] were significantly different among 0-8 group, 9-19 group and ≥20 group (all P<0.001). Multivariate logistic regression analysis showed that AFC was a significant factor affecting the number of oocytes retrieved ( P9-19/0-8=0.002, P≥20/0-8<0.001), and LH/FSH was an significant internal factor affecting the number of oocytes retrieved ( P9-19/0-8=0.006, P≥20/0-8=0.003) after the removal of AFC. Results of the analysis in patients after propensity score matching (PSM) showed that the number of oocytes retrieved was negatively correlated with oocyte maturation rate [0-8 group: 48.0% (242/504), 9-19 group: 44.8% (539/1202), ≥20 group: 40.4% (1067/2640), P=0.001], fertilization rate [0-8 group: 31.7% (160/504), 9-19 group: 25.5% (306/1202), ≥20 group∶ 23.7% (625/2640), P=0.001] and transferable embryo rate [0-8 group: 19.2% (97/504), 9-19 group: 11.6% (140/1202),≥20 group: 6.0% (153/2540), P<0.001], while positively correlated with transferable embryo formation cycle rate [0-8 group: 51.1% (47/92), 9-19 group: 66.3% (61/92), ≥20 group: 73.9% (68/92), P=0.005]. There were no differences in clinical pregnancy rate and live birth rate per fresh or frozen embryo transfer cycles, cumulative clinical pregnancy rate and cumulative live birth rate among the three groups. Conclusion:AFC has predictive value for the number of oocytes retrieved in natural cycles, and LH/FSH is an important internal factor affecting the number of oocytes retrieved. Oocyte maturation quality and development potential decrease with the increase of the number of oocytes retrieved in natural cycles, which has no direct effect on clinical outcomes.
