Comparison of live-birth rate after Freeze-All strategy between PCOS and non-PCOS patients

Abstract

Objective Polycystic Ovarian Syndrome (PCOS) is a common pathology and the most frequent cause of infertility linked to dysovulation. These patients have a high ovarian reserve and, as a result, oocyte collection is often excessive. Following medically assisted reproduction techniques, i.e. In Vitro Fertilisation (IVF), the literature remains discordant on the quality of these oocytes compared with those obtained in a non-PCOS population, as well as on the live-birth rate. Material and methods A single-centre retrospective observational study was conducted from January 2019 to December 2021 in patients with or without PCOS treated with an in vitro fertilisation ± intracytoplasmic sperm injection (IVF ± ICSI) protocol with freeze-all (FA). The primary objective was to compare the live birth rates between patients with PCOS versus the non-PCOS patients considered to be normo-responders and to estimate a cumulative live birth. The secondary objectives were to compare the number of oocytes retrieved, the maturity rate, the number of blastocysts obtained and the clinical pregnancy rates between these two groups of patients. Results Among the 173 freeze-all cycles included, live birth rates were not significantly different between the two groups, 39.6% in the PCOS group vs 33.9% in the non-PCOS group ( P = 0.65), unlike clinical pregnancy rates which were higher in PCOS patients, 65.8% versus 46.8% in the non-PCOS group ( P = 0.03). The number of oocytes collected, the number of blastocysts obtained and the number of blastocysts were significantly higher in the PCOS group (respectively 17.5 vs 14.8, P = 0.03; 7.6 vs 5.5, P = 0.005; 4.8 vs 3.3, P = 0.005). However, there was no significant difference between the rates of oocyte maturity, 81% in the PCOS group vs 82% in the control group, with P = 0.599. Conclusion To conclude, there was no significant difference between the two groups, PCOS and non-PCOS, in live birth rates and oocyte maturity rates. Patients with PCOS therefore do not, have a poorer prognosis in IVF ± ICSI with freeze-all than patients with a normal response.