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from Section IX - Hormones and the Environment
Published online by Cambridge University Press: 25 November 2021
The significant advances in ultrasound technology have resulted in an increase in the prevalence of PCO morphological ultrasonographic criteria diagnosis. These patients have a live birth rate after undergoing up to three cycles of IVF treatment that is 82% higher than women with normal ovaries, requiring fewer ampules of gonadotrophins, producing more follicles and viable oocytes with similar fertilisation and miscarriage rates. Since these women exhibit an exaggerated response to gonadotrophin therapy regardless of COH protocol, the risk remains the increased prevalence of OHSS. Since no COH protocol is superior to manage these patients, protocols that trigger oocyte maturation with a GnRH agonist, with or without a ‘freeze-all’ approach, should be encouraged. Therefore, it is important that every patient undergoing IVF has a baseline ultrasound scan, antral follicle count and AMH levels as well as an assessment of ovarian morphology prior to ART treatments in order to assess risk and reduce complications.
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