Natural-cycle in vitro fertilization (IVF) combined with in vitro maturation in infertile patients with polycystic ovarian syndrome (PCOS) requiring IVF

Claudia González-Ortega, Raul E. Piña-Aguilar, Patricia Cancino-Villarreal, Efraín Pérez-Peña, Antonio M. Gutiérrez-Gutiérrez* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

Objective: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients. Material and methods: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. In conventional IVF group, recombinant FSH (rFSH) and GnRH agonist/antagonist for ovarian stimulation were used. In both groups, fertilization was achieved by intracytoplasmic sperm injection (ICSI) of mature oocytes and fresh embryos transferred at day 2 or day 3. Results: In all IVF/M cycles oocytes and transferable quality embryos were obtained, only in 6 IVF/M cycles mature oocytes were obtained at oocyte capture day. Clinical pregnancy rate per cycle was 39.0% vs 53.6% (p = 0.0682) and delivery rate per cycle was 30.5% vs 42.6% (p = 0.1209) in IVF/M and conventional IVF respectively. Patients with ovarian hyperstimulation syndrome (OHSS) were 0% in IVF/M vs 6.7% in conventional IVF (p = 0.0399). Conclusion: Our experience in a private clinic in Mexico suggests that IVF/M can be a useful initial strategy to treat PCOS patients requiring IVF with comparable delivery rates to conventional IVF and a decreased risk of ovary hyperstimulation. IVF/M may be indicated to patients with limited resources paying without insurance for their infertility treatment.

Original languageEnglish
Pages (from-to)192-195
Number of pages4
JournalTaiwanese Journal of Obstetrics and Gynecology
Volume58
Issue number2
Early online date22 Mar 2019
DOIs
Publication statusPublished - Mar 2019

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Polycystic Ovary Syndrome
Fertilization in Vitro
Oocytes
In Vitro Oocyte Maturation Techniques
In Vitro Techniques
Embryonic Structures
Ovarian Hyperstimulation Syndrome
Intracytoplasmic Sperm Injections
Ovulation Induction
Pregnancy Rate

Keywords

  • In vitro maturation
  • Infertility
  • Mild approach
  • Patient friendly IVF
  • PCOS
  • Humans
  • Ovulation Induction/methods
  • Fertilization in Vitro/methods
  • Infertility, Female/etiology
  • In Vitro Oocyte Maturation Techniques/economics
  • Pregnancy
  • Young Adult
  • Oocyte Retrieval/methods
  • Adult
  • Female
  • Polycystic Ovary Syndrome/complications
  • Pregnancy Rate

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

Natural-cycle in vitro fertilization (IVF) combined with in vitro maturation in infertile patients with polycystic ovarian syndrome (PCOS) requiring IVF. / González-Ortega, Claudia; Piña-Aguilar, Raul E.; Cancino-Villarreal, Patricia; Pérez-Peña, Efraín; Gutiérrez-Gutiérrez, Antonio M. (Corresponding Author).

In: Taiwanese Journal of Obstetrics and Gynecology, Vol. 58, No. 2, 03.2019, p. 192-195.

Research output: Contribution to journalArticle

González-Ortega, Claudia ; Piña-Aguilar, Raul E. ; Cancino-Villarreal, Patricia ; Pérez-Peña, Efraín ; Gutiérrez-Gutiérrez, Antonio M. / Natural-cycle in vitro fertilization (IVF) combined with in vitro maturation in infertile patients with polycystic ovarian syndrome (PCOS) requiring IVF. In: Taiwanese Journal of Obstetrics and Gynecology. 2019 ; Vol. 58, No. 2. pp. 192-195.
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abstract = "Objective: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients. Material and methods: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. In conventional IVF group, recombinant FSH (rFSH) and GnRH agonist/antagonist for ovarian stimulation were used. In both groups, fertilization was achieved by intracytoplasmic sperm injection (ICSI) of mature oocytes and fresh embryos transferred at day 2 or day 3. Results: In all IVF/M cycles oocytes and transferable quality embryos were obtained, only in 6 IVF/M cycles mature oocytes were obtained at oocyte capture day. Clinical pregnancy rate per cycle was 39.0{\%} vs 53.6{\%} (p = 0.0682) and delivery rate per cycle was 30.5{\%} vs 42.6{\%} (p = 0.1209) in IVF/M and conventional IVF respectively. Patients with ovarian hyperstimulation syndrome (OHSS) were 0{\%} in IVF/M vs 6.7{\%} in conventional IVF (p = 0.0399). Conclusion: Our experience in a private clinic in Mexico suggests that IVF/M can be a useful initial strategy to treat PCOS patients requiring IVF with comparable delivery rates to conventional IVF and a decreased risk of ovary hyperstimulation. IVF/M may be indicated to patients with limited resources paying without insurance for their infertility treatment.",
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author = "Claudia Gonz{\'a}lez-Ortega and Pi{\~n}a-Aguilar, {Raul E.} and Patricia Cancino-Villarreal and Efra{\'i}n P{\'e}rez-Pe{\~n}a and Guti{\'e}rrez-Guti{\'e}rrez, {Antonio M.}",
note = "REPA is supported by CONACYT (329705) Mexico and Elphinstone scholarships and a fellowship from IBSA Foundation.",
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AU - Piña-Aguilar, Raul E.

AU - Cancino-Villarreal, Patricia

AU - Pérez-Peña, Efraín

AU - Gutiérrez-Gutiérrez, Antonio M.

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N2 - Objective: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients. Material and methods: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. In conventional IVF group, recombinant FSH (rFSH) and GnRH agonist/antagonist for ovarian stimulation were used. In both groups, fertilization was achieved by intracytoplasmic sperm injection (ICSI) of mature oocytes and fresh embryos transferred at day 2 or day 3. Results: In all IVF/M cycles oocytes and transferable quality embryos were obtained, only in 6 IVF/M cycles mature oocytes were obtained at oocyte capture day. Clinical pregnancy rate per cycle was 39.0% vs 53.6% (p = 0.0682) and delivery rate per cycle was 30.5% vs 42.6% (p = 0.1209) in IVF/M and conventional IVF respectively. Patients with ovarian hyperstimulation syndrome (OHSS) were 0% in IVF/M vs 6.7% in conventional IVF (p = 0.0399). Conclusion: Our experience in a private clinic in Mexico suggests that IVF/M can be a useful initial strategy to treat PCOS patients requiring IVF with comparable delivery rates to conventional IVF and a decreased risk of ovary hyperstimulation. IVF/M may be indicated to patients with limited resources paying without insurance for their infertility treatment.

AB - Objective: In this study, we report an experience of 59 natural-cycle IVF combined with in vitro oocyte maturation (IVF/M) cycles in patients with PCOS requiring IVF recruited based on limitations to afford a conventional IVF treatment in a 9-years period. Results of IVF/M were compared with 164 cycles of IVF in PCOS patients. Material and methods: In IVF/M cycles only hCG priming was used before oocyte recovery, with in vitro maturation of immature oocytes in a commercial medium. In conventional IVF group, recombinant FSH (rFSH) and GnRH agonist/antagonist for ovarian stimulation were used. In both groups, fertilization was achieved by intracytoplasmic sperm injection (ICSI) of mature oocytes and fresh embryos transferred at day 2 or day 3. Results: In all IVF/M cycles oocytes and transferable quality embryos were obtained, only in 6 IVF/M cycles mature oocytes were obtained at oocyte capture day. Clinical pregnancy rate per cycle was 39.0% vs 53.6% (p = 0.0682) and delivery rate per cycle was 30.5% vs 42.6% (p = 0.1209) in IVF/M and conventional IVF respectively. Patients with ovarian hyperstimulation syndrome (OHSS) were 0% in IVF/M vs 6.7% in conventional IVF (p = 0.0399). Conclusion: Our experience in a private clinic in Mexico suggests that IVF/M can be a useful initial strategy to treat PCOS patients requiring IVF with comparable delivery rates to conventional IVF and a decreased risk of ovary hyperstimulation. IVF/M may be indicated to patients with limited resources paying without insurance for their infertility treatment.

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KW - Young Adult

KW - Oocyte Retrieval/methods

KW - Adult

KW - Female

KW - Polycystic Ovary Syndrome/complications

KW - Pregnancy Rate

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