Comparison between IVF antagonist protocol versus ivm protocol to treat infertile PCOS patients. a prospective randomized study. preliminary results

ObjectiveTriggering ovulation with GnRH-agonist in GnRH antagonist protocols can prevent Ovarian-HyperStimulation Syndrome (OHSS) in PolyCystic Ovarian Syndrome (PCOS) patients. However large amounts of gonadotropins are used.In-Vitro Maturation (IVM) may be a potential alternative for these patients, without exposure to gonadotropins and risk of OHSS. The aim of this study was to compare the outcomes of IVM versus antagonist protocols in PCOS patients.DesignA prospective randomized controlled trial.Materials and MethodsPCOS patients were enrolled randomly to IVM or antagonist protocol. Patients in IVM group were primed with 150IU rFSH for 3 days and hCG . Patients in the antagonist protocol were treated routinely. The two groups were compared regarding the number of oocytes retrieved, maturation rate / mature oocytes, fertilization and cleavage rates, quality of embryos, OHSS and ongoing pregnancy rates.Results11 and 10 patients were recruited so far for antagonist and IVM protocol. No significant differences in number of mature oocytes (11.2±5.7 vs.12.2±8.45), fertilization rate (73% vs. 67%) and top quality of embryos (45.3% vs. 43.9) were observed. The average dose of gonadotropins in the antagonist protocol was 1461 IU±560IU per cycle, compared to 382±108IU in the IVM group (p < 0.001) . Pregnancy rates were comparable - only 9% (1/11) in the antagonist (surprisingly low compared to previous data from our unit of 38% ) and 40% in the IVM group (4/10) (p=0.102). No OHSS developed.ConclusionIVM protocol may be an alternative for infertile women with PCOS who desire to prevent potential adverse effects of gonadotropins treatment and prevent OHSS. These preliminary data demonstrate that IVM has comparable results to standard IVF treatments. ObjectiveTriggering ovulation with GnRH-agonist in GnRH antagonist protocols can prevent Ovarian-HyperStimulation Syndrome (OHSS) in PolyCystic Ovarian Syndrome (PCOS) patients. However large amounts of gonadotropins are used.In-Vitro Maturation (IVM) may be a potential alternative for these patients, without exposure to gonadotropins and risk of OHSS. The aim of this study was to compare the outcomes of IVM versus antagonist protocols in PCOS patients. Triggering ovulation with GnRH-agonist in GnRH antagonist protocols can prevent Ovarian-HyperStimulation Syndrome (OHSS) in PolyCystic Ovarian Syndrome (PCOS) patients. However large amounts of gonadotropins are used.In-Vitro Maturation (IVM) may be a potential alternative for these patients, without exposure to gonadotropins and risk of OHSS. The aim of this study was to compare the outcomes of IVM versus antagonist protocols in PCOS patients. DesignA prospective randomized controlled trial. A prospective randomized controlled trial. Materials and MethodsPCOS patients were enrolled randomly to IVM or antagonist protocol. Patients in IVM group were primed with 150IU rFSH for 3 days and hCG . Patients in the antagonist protocol were treated routinely. The two groups were compared regarding the number of oocytes retrieved, maturation rate / mature oocytes, fertilization and cleavage rates, quality of embryos, OHSS and ongoing pregnancy rates. PCOS patients were enrolled randomly to IVM or antagonist protocol. Patients in IVM group were primed with 150IU rFSH for 3 days and hCG . Patients in the antagonist protocol were treated routinely. The two groups were compared regarding the number of oocytes retrieved, maturation rate / mature oocytes, fertilization and cleavage rates, quality of embryos, OHSS and ongoing pregnancy rates. Results11 and 10 patients were recruited so far for antagonist and IVM protocol. No significant differences in number of mature oocytes (11.2±5.7 vs.12.2±8.45), fertilization rate (73% vs. 67%) and top quality of embryos (45.3% vs. 43.9) were observed. The average dose of gonadotropins in the antagonist protocol was 1461 IU±560IU per cycle, compared to 382±108IU in the IVM group (p < 0.001) . Pregnancy rates were comparable - only 9% (1/11) in the antagonist (surprisingly low compared to previous data from our unit of 38% ) and 40% in the IVM group (4/10) (p=0.102). No OHSS developed. 11 and 10 patients were recruited so far for antagonist and IVM protocol. No significant differences in number of mature oocytes (11.2±5.7 vs.12.2±8.45), fertilization rate (73% vs. 67%) and top quality of embryos (45.3% vs. 43.9) were observed. The average dose of gonadotropins in the antagonist protocol was 1461 IU±560IU per cycle, compared to 382±108IU in the IVM group (p < 0.001) . Pregnancy rates were comparable - only 9% (1/11) in the antagonist (surprisingly low compared to previous data from our unit of 38% ) and 40% in the IVM group (4/10) (p=0.102). No OHSS developed. ConclusionIVM protocol may be an alternative for infertile women with PCOS who desire to prevent potential adverse effects of gonadotropins treatment and prevent OHSS. These preliminary data demonstrate that IVM has comparable results to standard IVF treatments. IVM protocol may be an alternative for infertile women with PCOS who desire to prevent potential adverse effects of gonadotropins treatment and prevent OHSS. These preliminary data demonstrate that IVM has comparable results to standard IVF treatments.