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Impact of body mass index on intracytoplasmic sperm injection in women with polycystic ovary syndrome

Published online by Cambridge University Press:  18 January 2021

Stanly Kamardi
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia
IGN Harry Wijaya Surya
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia
I Nyoman Bayu Mahendra
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia
IB Putra Adnyana
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia Bali Royal Hospital, Royal IVF Clinic, Denpasar-Bali, Indonesia
Anom Suardika
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia Bali Royal Hospital, Royal IVF Clinic, Denpasar-Bali, Indonesia
Nono Tondohusodo
Affiliation:
Obstetrics and Gynaecology Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia Bali Royal Hospital, Royal IVF Clinic, Denpasar-Bali, Indonesia
Jaqueline Sudiman*
Affiliation:
Bali Royal Hospital, Royal IVF Clinic, Denpasar-Bali, Indonesia Anatomy Department, Faculty of Medicine, Udayana University, Denpasar-Bali, Indonesia
*
Author for correspondence: Jaqueline Sudiman. Bali Royal Hospital, Royal IVF Clinic, Denpasar-Bali, Indonesia. E-mail: [email protected]; [email protected]

Summary

Polycystic ovary syndrome (PCOS) is a condition that affects fertility. There are two types of PCOS; the normal/lean type and overweight/obese type. The aim of this study was to assess baseline characteristics, ovarian response, quality of oocytes, embryos, pregnancy, implantation and live birth rates in normal/lean and overweight/obese patients with PCOS undergoing ICSI compared with patients without PCOS. This retrospective case–control analytical study included 38 normal/lean and 17 overweight/obese patients with PCOS, and 98 normal/lean and 17 overweight/obese patients without PCOS. Parameters were observed based on baseline characteristics, ovarian response to dosage and duration of gonadotropin administered, number of oocytes, matured oocytes, fertilization rate, embryo quality and development, pregnancy, implantation and live birth rates. Basal serum luteinizing hormone in normal/lean PCOS was significantly higher compared with non-PCOS groups. Total dosage of gonadotropin used was significantly lower in normal/lean PCOS compared with other groups. End estradiol levels in normal/lean PCOS was significantly higher compared with the non-PCOS groups. Number of follicles, retrieved oocytes and matured oocytes were significantly higher in PCOS groups compared with the non-PCOS groups. However, there were no differences in fertilized oocytes, cleavage, number of top-quality embryos, pregnancy, implantation, and live birth rates among groups. This present study suggests that normal/lean PCOS requires lower gonadotropin dosages and that patients with PCOS have more follicles and oocytes compared with patients without PCOS, however the number of fertilized oocytes and embryos from patients with PCOS were the same as those from patients without PCOS and suggested that the quality of retrieved oocytes in PCOS might be compromised.

Type
Research Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

American College of Obstetricians and Gynecologists (1998). Precis , Reproductive Endocrinology: An Update in Obstetrics and Gynecology. Danvers: Copyright Clearance Center, pp. 92103.Google Scholar
Bailey, AP, Hawkins, LK, Missmer, SA, Correia, KF and Yanushpolsky, EH (2014). Effect of body mass index on in vitro fertilization outcomes in women with polycystic ovary syndrome. Am J Obstet Gynecol 211, 163e161–6.CrossRefGoogle ScholarPubMed
Barbosa, G, de Sá, LBPC, Rocha, DRTW and Arbex, AK (2016). Polycystic ovary syndrome (PCOS) and fertility. OJEMD 6, 5866.CrossRefGoogle Scholar
Bergh, CM, Moore, M and Gundell, C (2016). Evidence-Based management of infertility in women with polycystic ovary syndrome. J Obstet Gynecol Neonatal Nurs 45, 111–22.CrossRefGoogle ScholarPubMed
Beydoun, HA, Stadtmauer, L, Zhao, Y, Russell, H, Matson, DO and Oehninger, S (2009). Impact of polycystic ovary syndrome on selected indicators of in vitro fertilization and intracytoplasmic sperm injection treatment success. J Womens Health (Larchmt) 18, 717–23.CrossRefGoogle ScholarPubMed
Bu, Z, Dai, W, Guo, Y, Su, Y, Zhai, J and Sun, Y (2013). Overweight and obesity adversely affect outcomes of assisted reproductive technologies in polycystic ovary syndrome patients. Int J Clin Exp Med 6, 991–5.Google ScholarPubMed
Dokras, A, Baredziak, L, Blaine, J, Syrop, C, Van Voorhis, BJ and Sparks, A (2006). Obstetric outcomes after in vitro fertilization in obese and morbidly obese women. Obstet Gynecol 108, 61–9.CrossRefGoogle ScholarPubMed
Dong, X, Liao, X, Wang, R and Zhang, H (2013). The impact of endometriosis on IVF/ICSI outcomes. Int J Clin Exp Pathol 6, 1911–8.Google ScholarPubMed
Fauser, BC, Tarlatzis, BC, Rebar, RW, Legro, RS, Balen, AH, Lobo, R, Carmina, E, Chang, J, Yildiz, BO, Laven, JS, Boivin, J, Petraglia, F, Wijeyeratne, CN, Norman, RJ, Dunaif, A, Franks, S, Wild, RA, Dumesic, D and Barnhart, K (2012). Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 97, 2838.CrossRefGoogle ScholarPubMed
Fedorcsak, P, Storeng, R, Dale, PO, Tanbo, T, Torjesen, P, Urbancsek, J and Abyholm, T (2000). Leptin and leptin binding activity in the preovulatory follicle of polycystic ovary syndrome patients. Scand J Clin Lab Invest 60, 649–55.Google ScholarPubMed
Fedorcsak, P, Dale, PO, Storeng, R, Tanbo, T and Abyholm, T (2001). The impact of obesity and insulin resistance on the outcome of IVF or ICSI in women with polycystic ovarian syndrome. Hum Reprod 16, 1086–91.CrossRefGoogle ScholarPubMed
Huang, K, Liao, X, Dong, X and Zhang, H (2014). Effect of overweight/obesity on IVF-ET outcomes in chinese patients with polycystic ovary syndrome. Int J Clin Exp Med 7, 5872–6.Google ScholarPubMed
Jia, L, Li, J, He, B, Jia, Y, Niu, Y, Wang, C and Zhao, R (2016). Abnormally activated one-carbon metabolic pathway is associated with mtDNA hypermethylation and mitochondrial malfunction in the oocytes of polycystic gilt ovaries. Sci Rep 6, 19436.CrossRefGoogle ScholarPubMed
Kalem, MN, Kalem, Z, Sari, T, Ates, C and Gurgan, T (2016). Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome. J Turk Ger Gynecol Assoc 17, 8390.CrossRefGoogle ScholarPubMed
Kini, S (2012). Polycystic ovary syndrome: diagnosis and management of related infertility. Obstet Gynaecol Reprod Med 22, 347–53.CrossRefGoogle Scholar
Kriedt, KJ, Alchami, A and Davies, MC (2019). PCOS: diagnosis and management of related infertility. Obstet Gynaecol Reprod Med 19, 15.CrossRefGoogle Scholar
McCartney, ChR and Marshall, JC (2016). Polycystic ovary syndrome. N Engl J Med 375, 1398–9.CrossRefGoogle ScholarPubMed
McCormick, B, Thomas, M, Maxwell, R, Williams, D and Aubuchon, M (2008). Effects of polycystic ovarian syndrome on in vitro fertilization-embryo transfer outcomes are influenced by body mass index. Fertil Steril 90, 2304–9.CrossRefGoogle ScholarPubMed
Mulders, AG, Laven, JS, Imani, B, Eijkemans, MJ and Fauser, BC (2003). IVF outcome in anovulatory infertility (WHO group 2)—including polycystic ovary syndrome—following previous unsuccessful ovulation induction. Reprod Biomed Online 7, 50–8.CrossRefGoogle ScholarPubMed
O’Neill, KE, Senapati, S and Dokras, A (2015). Use of gonadotropin-releasing hormone agonist trigger during in vitro fertilization is associated with similar endocrine profiles and oocyte measures in women with and without polycystic ovary syndrome. Fertil Steril 103, 264–9.CrossRefGoogle ScholarPubMed
Purnell, JQ (2018). Definitions, Classification, and Epidemiology of Obesity. 2018 Apr 12. In: Feingold, KR, Anawalt, B, Boyce, A, Chrousos, G, de Herder, WW, Dungan, K, Grossman, A, Hershman, JM, Hofland, HJ, Kaltsas, G, Koch, C, Kopp, P, Korbonits, M, McLachlan, R, Morley, JE, New, M, Purnell, J, Singer, F, Stratakis, CA, Trence, DL and Wilson, DP (eds). Endotext [Internet]. South Dartmouth (MA): MDText.com.Google Scholar
Rehman, R, Mehmood, M, Ali, R, Shaharyar, S and Alam, F (2018). Influence of body mass index and polycystic ovarian syndrome on ICSI/IVF treatment outcomes: A study conducted in Pakistani women. Int J Reprod Biomed (Yazd) 16, 529–34.Google ScholarPubMed
Teede, H, Misso, M, Costello, M, Dokras, A, Laven, J, Moran, L, Piltonen, T and Norman, R on behalf of the International PCOS Network (2018). International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Melbourne: Monash University; Australian Government National Health and Medical Research Council.Google ScholarPubMed
Wang, F, Dai, W, Yang, XH, Guo, YH and Sun, YP (2016). Analyses of optimal body mass index for infertile patients with either polycystic or non-polycystic ovary syndrome during assisted reproductive treatment in China. Sci Rep 6, 34538.CrossRefGoogle ScholarPubMed
Wilson, EE (2008). Polycystic Ovarian Syndrome and Hyperandrogenism. McGraw-Hill, New York.Google Scholar