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In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproductionSiristatidis CS, Maheshwari A, Bhattacharya S
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SummaryIn vitro maturation in sub-fertile women with polycystic ovarian syndrome who are undergoing assisted reproduction.Women with polycystic ovarian syndrome undergoing conventional assisted reproduction techniques are at an increased risk of ovarian hyperstimulation, This is often associated with the retrieval of immature oocytes, poor fertilisation, and low pregnancy rates. These women might benefit from the earlier retrieval of oocytes followed by their maturation in the laboratory (IVM) thus reducing the risk of ovarian hyperstimulation. Successful fertilisation, embryo development, and term pregnancies resulting from IVM oocytes have been reported, along with some concern regarding the safety of the method with respect to the health of the children and the rate of congenital anomalies.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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January 21. 2009 AbstractBackgroundPolycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM). ObjectivesTo compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART. Search strategyWe searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials. Selection criteriaAll randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS. Data collection and analysisWe identified no studies that met the inclusion criteria. Main resultsThere were no trials suitable for inclusion in the review. Authors' conclusionsThere are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field. |