Comparison of oocyte quality and intracytoplasmic sperm injection outcome in women with isolated polycystic ovaries or polycystic ovarian syndrome.

OBJECTIVE

To compare the oocyte quality and intracytoplasmic sperm injection performance in women with isolated polycystic ovaries or polycystic ovarian syndrome.

DESIGN

Retrospective study.

SETTING

Fertility unit.

POPULATION

Three study groups were identified: women with PCO-only morphology (50 cycles), PCOS (51 cycles) and age matched control group (104 cycles) with isolated male factor infertility necessitating ICSI.

METHOD

Controlled ovarian hyperstimulation and ICSI.

MAIN OUTCOME MEASURES

Response to gonadotropin stimulation, oocyte and embryo quality, clinical pregnancy rate and pregnancy outcome.

RESULTS

Despite a significantly lower total gonadotropin dose, a significantly higher serum E2 level was attained in both the PCOS and the PCO-only groups compared to the control group. Although significantly more oocytes were retrieved in the PCOS and PCO-only groups, the number of 2-pronuclear embryos was similar to controls. No significant differences were noted in the maturity of the oocytes, oocyte dysmorphism, embryo quality, implantation and pregnancy rates among the three groups. However the clinical miscarriage rate was significantly lower in women with PCO-only morphology group (15.4 versus 31%, P < 0.05) than in the PCOS group.

CONCLUSION

Women with PCO-only appearance have shown to have similar characteristics to women with PCOS in terms of ovarian response to hMG stimulation, oocyte and embryo quality and pregnancy rates. However miscarriage rates were significantly lower in the PCO-only group than the PCOS group. Our findings suggest that factors unrelated to oocyte and embryo morphology present in PCOS patients may be instrumental in adverse reproductive outcomes in these women.