Individualized In Vitro Fertilization And Embryo Transfer(IVF-ET) Treatment For Polycystic Ovary Syndrome(PCOS) Patients

ObjectivePart one: To compare the pregnancy outcomes of patients with polycystic ovary syndrome(PCOS)and age-matched infertile patients with pelvic,tubal and / or male factors(non-PCOS)after first in vitro fertilization and embryo transfer(IVF-ET)treatment cycle.Part two: Compare the standard long protocol,long-acting GnRH agonist(GnRH-a)follicular protocol and GnRH antagonist(GnRH-ant)protocol in PCOS patients to explore the choice of controlled ovarian hyperstimulation(COH)scheme and whether the plan has any influence on pregnancy outcome of PCOS patients.MethodsThis study retrospectively analyzed 215 patients with PCOS who received the first IVF/ICSI-ET in the reproductive center of the first affiliated hospital of Shantou university medical college from October 2016 to September 2019.They were matched by age and randomly selected 430 patients at a ratio of 1:2 served as the control group with pelvic factors,tubal factors and/ or male factors.Part one: The pregnancy outcomes of the whole fresh embryo transfer cycle and the first transfer cycle after freezing-all policy were compared between PCOS patients and non-PCOS patients.And then,according to different ovarian hyperstimulation protocols,these patients were divided into three groups: the standard long protocol group,the long-acting GnRH-a follicular protocol group and GnRH-ant protocol group.We compared baseline data,clinical,laboratory data,and pregnancy outcomes between the two groups in each protocol.Part two: The baseline data,clinical and laboratory data and pregnancy outcomes of three COH regimens were compared in PCOS womenpopulation.ResultsPart one: No significant difference showed in the overall ovarian hyperstimulation syndrome(OHSS)rate and pregnancy outcome between PCOS patients and non-PCOS patients in fresh cycle,but the pregnancy rate and live birth rate of PCOS patients were significantly higher than those of ordinary infertility patients in the first FET cycle(P < 0.05).Part two: 1)Among the three COH regimens in PCOS patients,the ratio of basal LH/ basal FSH(b LH /b FSH)and antral follicle count(AFC)of PCOS patients were the lowest in standard long protocol(P < 0.05),and the AMH in antagonist protocol was the highest(P < 0.05);2)The fresh embryo transfer rate of PCOS patients was the highest in the long-acting GnRH-a follicular protocol(P < 0.05),but the OHSS rate and pregnancy outcome of fresh cycle in the three schemes was similar,and their pregnancy outcome of each scheme was no worse than that of ordinary infertility patients.Logistic regression analysis did not reveal the significant influencing factors of live birth rate of PCOS patients in fresh cycle.;3)In addition,the number of blastocysts and live birth rate in the first FET cycle of PCOS patients were significantly higher than those in the fresh cycle(P < 0.05).Logistic regression analysis showed that they were positive correlated.ConclusionsIn the first IVF-ET treatment,even with different COH regimens,PCOS patients have the same pregnancy outcomes as those with infertility due to pelvic,tubal and / or male factors(non-PCOS),and OHSS did not increase significantly.