Comparison of in vitro fertilization outcomes between patients with and without polycystic ovary syndrome

This study aims to investigate the increased risk of adverse pregnancy outcomes on patients who have a polycystic ovary syndrome (PCOS) with high ovarian response. The data of patients (3841 cycles) with ovarian high response who conceive in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in our hospital from January 2016 to June 2020 were picked out. According to with or without PCOS, the cycles were divided into PCOS group and non-PCOS group. After propensity score matching matching, 649 cycles in each group were analyzed. There was no significant difference in general conditions between the 2 groups (P > .05), but the Anti-Müllerian hormone (8.30 ± 3.96 vs 6.36 ± 3.42; P < .001***) and Antral follicle count (AFC) (22.71 ± 4.56 vs 19.56 ± 5.66; P < .001***) of PCOS group were significantly higher than those of non-PCOS group. No significant differences were found in the thickness of endometrium on the day of human chorionic gonadotropin (hCG) day (12.28 ± 2.38 vs 12.18 ± 2.41; P = .444) but progesterone (0.97 ± 0.57 vs 1.16 ± 0.69; P < .001***) was remarkably lower than that in non-PCOS group. Number of oocytes retrieved (23.33 ± 6.45 vs 22.57 ± 5.73; P = .025*), high-quality embryo rate (60.6 vs 53.6; P < .001***) and high-quality blastocyst rate (15.2 vs 11.5; P < .001***) were significantly higher in the PCOS group than those in the non-PCOS group. The rates of freezing all embryos cycles due to high ovarian response (52.4 vs 43.1; P = .001**), clinical pregnancy (84.2 vs 74.0; P = .012*) and live birth (73.8 vs 61.2; P = .001**) were all significantly higher in PCOS group than non-PCOS group, however, with no significant difference in the rates of preterm birth (6.3 vs 9.9; P = .153), ovarian hyperstimulation syndrome (OHSS) (3.5 vs 3.7; P = .179) and OHSS in clinical pregnancy (3.2 vs 3.8; P = .067) between the 2 groups were found. These findings suggest that tailored treatment protocols, including individualized ovarian stimulation strategies and careful management of OHSS, may optimize reproductive outcomes in high-response PCOS patients.