Rescue In Vitro Maturation in Polycystic Ovarian Syndrome Patients Undergoing In Vitro Fertilization Treatment who Overrespond or Underrespond to Ovarian Stimulation: Is It A Viable Option? A Case Series Study

Authors

  • Anni Ding Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Ayesha Bhevan Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Caroline Ross Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Karen Turner Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Marie-Eve Bergeron Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Muhammad Fatum Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
  • Tim Child Oxford Fertility Unit, Institute of Reproductive Sciences, Oxford, United Kingdom
Abstract:

Background: This study intends to present the role of rescue in vitro maturation (IVM) in polycystic ovarian syndrome(PCOS) patients undergoing in vitro fertilization (IVF) treatment who have inappropriate responses to ovarianstimulation.Materials and Methods: This was a retrospective case series study of five PCOS patients undergoing IVF treatmentconsidered for cycle cancellation due to increased risk of ovarian hyperstimulation syndrome (OHSS) as group A orpoor response to ovarian stimulation as group B. Patients in group A had high oestradiol levels and recruitment of highnumbers of small/intermediate sized follicles that did not meet the criteria for human chorionic gonadotropin (hCG)triggering. Patients in group B responded inadequately to hormonal stimulation despite high gonadotropin dosage.Treatment was changed to rescue IVM cycles after the patients provided consent.Results: In group A, three IVF patients deemed to have high chances of developing OHSS as evidenced by highoestradiol levels were converted to IVM. A total of the 58/68 oocytes retrieved were mature or matured in vitro. Therewere 26 cleaving embryos obtained. Two patients had live births and one patient suffered a miscarriage. In group B,rescue IVM was implemented in two patients due to poor ovarian response (POR). A total of 22/26 oocytes retrievedwere mature or matured in vitro. There were 13 cleaving embryos obtained. One patient had a live birth, whilst theother suffered a miscarriage.Conclusion: Rescue IVM could be a viable option in PCOS patients undergoing IVF treatment who are unable tosafely meet the criteria for hCG triggering due to overresponse to ovarian stimulation or ovarian resistance to highdoses of stimulation. Conversion to IVM can still result in reasonable oocyte retrieval and lead to clinical pregnancyand live births without the risks of OHSS.

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volume 14  issue 2

pages  137- 142

publication date 2020-07-01

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