In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction

Charalambos Siristatidis, Abha Maheshwari, Siladitya Bhattacharya

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Abstract

BACKGROUND: Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). OBJECTIVES: To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. SELECTION CRITERIA: All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. DATA COLLECTION AND ANALYSIS: We identified no studies that met the inclusion criteria. MAIN RESULTS: There were no trials suitable for inclusion in the review. AUTHORS' CONCLUSIONS: There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.
Original languageEnglish
Article numberCD006606
JournalCochrane Database of Systematic Reviews
Issue number1
DOIs
Publication statusPublished - 21 Jan 2009

Fingerprint

Polycystic Ovary Syndrome
Reproduction
Intracytoplasmic Sperm Injections
Fertilization in Vitro
Infertility
Assisted Reproductive Techniques
In Vitro Oocyte Maturation Techniques
Ovarian Hyperstimulation Syndrome
Oocyte Retrieval
In Vitro Techniques
Birth Rate
Live Birth
Gonadotropins
MEDLINE
Fertility
Language
Software
Randomized Controlled Trials
Databases
Guidelines

Keywords

  • Female
  • Fertilization in Vitro
  • Humans
  • Infertility, Female
  • Oocyte Retrieval
  • Oocytes
  • Polycystic Ovary Syndrome
  • Sperm Injections, Intracytoplasmic

Cite this

@article{b93f8ef2550b4547b5f7483a320d47cc,
title = "In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction",
abstract = "BACKGROUND: Polycystic ovarian syndrome (PCOS) occurs in 4{\%} to 7{\%} of all women of reproductive age and 20{\%} of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). OBJECTIVES: To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. SELECTION CRITERIA: All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. DATA COLLECTION AND ANALYSIS: We identified no studies that met the inclusion criteria. MAIN RESULTS: There were no trials suitable for inclusion in the review. AUTHORS' CONCLUSIONS: There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.",
keywords = "Female, Fertilization in Vitro, Humans, Infertility, Female, Oocyte Retrieval, Oocytes, Polycystic Ovary Syndrome, Sperm Injections, Intracytoplasmic",
author = "Charalambos Siristatidis and Abha Maheshwari and Siladitya Bhattacharya",
year = "2009",
month = "1",
day = "21",
doi = "10.1002/14651858.CD006606.pub2",
language = "English",
journal = "Cochrane Database of Systematic Reviews",
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TY - JOUR

T1 - In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction

AU - Siristatidis, Charalambos

AU - Maheshwari, Abha

AU - Bhattacharya, Siladitya

PY - 2009/1/21

Y1 - 2009/1/21

N2 - BACKGROUND: Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). OBJECTIVES: To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. SELECTION CRITERIA: All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. DATA COLLECTION AND ANALYSIS: We identified no studies that met the inclusion criteria. MAIN RESULTS: There were no trials suitable for inclusion in the review. AUTHORS' CONCLUSIONS: There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.

AB - BACKGROUND: Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). OBJECTIVES: To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. SEARCH STRATEGY: We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. SELECTION CRITERIA: All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. DATA COLLECTION AND ANALYSIS: We identified no studies that met the inclusion criteria. MAIN RESULTS: There were no trials suitable for inclusion in the review. AUTHORS' CONCLUSIONS: There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.

KW - Female

KW - Fertilization in Vitro

KW - Humans

KW - Infertility, Female

KW - Oocyte Retrieval

KW - Oocytes

KW - Polycystic Ovary Syndrome

KW - Sperm Injections, Intracytoplasmic

U2 - 10.1002/14651858.CD006606.pub2

DO - 10.1002/14651858.CD006606.pub2

M3 - Article

C2 - 19160291

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 1

M1 - CD006606

ER -