Impact of various PCOS phenotypes on oocyte competence in an ART cycle

Abstract

Introduction: PCOS is a common cause of female infertility. Although PCOS patients are characterized by producing an increased number of oocytes, they are often of poor quality, leading to lower fertilization, cleavage, and implantation and higher miscarriage rates. Aims: The present study aims to identify the effect of various PCOS phenotypes on oocyte competence in an ART cycle. Settings and design: A retrospective observational study. Methods and material: The study group included 102 women with PCOS as a main cause of infertility. Data was collected over a period of one year (2017-18). These women were divided into four groups on basis of PCOS phenotypes (A-D) and the relevant clinical data and the ART outcome were noted. Statistical analysis was done using SPSS statistical package. Data presented as mean ± SD which was compared using the ANOVA test. A p - value < 0.05 was considered statistically significant. Results: Out of 102 PCOS women, 23.52% women had phenotype A, 11.76% had phenotype B, and 45.09% and 19.60% had phenotype C & D respectively. Good quality embryos formed (p - value 0.01) were lower in Group B vs. other groups. However, clinical pregnancy rates were comparable in all groups. Conclusion: The reproductive potential of women with PCOS varies with the oocyte health and it largely depends on PCOS phenotype. Women with PCOS phenotype B might have poor IVF/ICSI outcomes with regard to the number of oocytes retrieved and embryos formed. PCO morphology might carry an advantage with regards to the number of oocytes retrieved and better quality embryos. It seems that hyperandrogenism in combination with chronic anovulation is associated with poor oocyte competence and hence, a negative impact on embryo quality and clinical pregnancy rate. Further studies with a larger sample size are required to further support it. Key messages: Oocyte competence in various PCOS phenotypes.