Comparison Of Icsi Cycles In Normo-Ovulatory Patients And In Polycystic Ovarian Syndrome Patients

OBJECTIVE The aim of this study was to compare the treatment outcome in patients with and without polycystic ovary syndrome undergoing ICSI cycles.PATIENTS AND METHODS We studied retrospectively 33 controlled ovarian stimulation cycles for ICSI in 19 normo-ovulatory women and 25 cycles in 13 women with PCOS. The main outcome measures evaluated were: cancellation of the cycles, number of aspirated follicles and percentage of oocyte recovery, oocyte maturity, fertilization rate, pregnancy and implantation rates, and clinical abortion rate. Fischer's test was used for differences between normo-ovulatory and PCOS patients and the limit of significance was set at p < 0.05.RESULTS PCOS patients showed a higher cancellation rate of controlled ovarian stimulation cycles (20.0% versus 9.0%, p = 0.21). The mean number of follicles was higher in patients with PCOS (16.5 versus 10.2), but these patients showed a lower oocyte recovery percentage (55.9% versus 71.8%, p < 0.001) when compared to normo-ovulatory patients undergoing ICSI. Oocyte maturity (group A: 85.9%; group B: 83.7%), fertilization rate (group A: 88.8%; group B: 86.4%), pregnancy and implantation rates (group A: 27.2% and 14.8%; group B: 20.0% and 11.8%) did not differ significantly in the two groups. In group A there was one miscarriage in 9 clinical pregnancies (11.1%) and in group B there were 2 miscarriages in 5 clinical pregnancies (40.0%) (p = 0.27).CONCLUSIONS The findings of this study suggest that pregnancy and implantation rates are not different in normo-ovulatory women and PCOS patients undergoing ICSI, but the higher clinical abortion rate gives evidence that deleterious factors not connected to oocyte morphology may be present in PCOS patients.