Oocyte quality in polycystic ovaries revisited: Identification of a particular subgroup of women |
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Authors: | Fidel Cano Juan A García-Velasco Antón Millet José Remohí Carlos Simón Antonio Pellicer |
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Institution: | 1. Instituto Valenciano de Infertilidad, Valencia, Spain 3. Department of Obstetrics and Gynecology, Hospital Clínico Universitario, Valencia, Spain 4. Department of Pediatrics, Obstetrics and Gynecology, Valencia University School of Medicine, Valencia, Spain
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Abstract: | Purpose: Our purpose was to assess the endocrine status of women with polycystic ovaries (PCO) undergoing IVF, and to compare oocyte
quality with endocrine markers of the syndrome, in an attempt to define a subpopulation with poor quality oocytes.
Methods: This was a retrospective study. Patients were first endocrinologically analyzed: serum levels of androgens (T, androstenedione,
DHEAS), FSH, and LH as well as glucose and insulin after an oral glucose tolerance test (OGTT) were recorded and are expressed
as absolute values and area under the curve (AUC). Subsequently, they were followed over a 2-year period in which patients
underwent several attempts of IVF as well as serving as oocyte donors. Patients were divided into three groups: group I (n=4)
was women who displayed embryos unable to implant in 15 IVF cycles and 10 ovum donation cycles in which they served as donors;
group II (n=16) was PCO patients in whom IVF (n=38) and/or oocyte donation cycles (n=42) resulted in pregnancies; and group
III (n=13) was IVF patients with normal appearance of the ovaries by ultrasound. The endocrine status was compared with the
IVF results.
Results: There was no difference among groups in the endocrinological parameters tested, except for the OGTT which identified women
in group I as having higher serum glucose and insulin levels than patients in groups II and III. Similarly, the OGTT showed
higher serum glucose values in group II compared to group III. Women in group I were also obese. Patients in group III were
older than PCO patients and needed more gonadotropins to reach an ovarian response which resulted in a reduced number of oocytes
retrieved. Fertilization was also impaired in group I, in which no pregnancy was recorded.
Conclusions: This study shows that there is a particular subgroup of PCO patients with lower fertilization rates and embryos unable to
implant. These patients are obese and nonhyperandrogenic and show derangements of insulin secretion. |
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Keywords: | polycystic ovary oocyte quality insulin resistance in vitro fertilization insulin glucose |
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