Related Experiment Video
Updated: Apr 16, 2026
Fertility Preservation Through Oocyte Vitrification: Clinical and Laboratory Perspectives
Published on: September 16, 2021
Lean Polycystic Ovarian Syndrome Has Better Responses toRecombinant Follicle-Stimulating Hormone Compared to
Radan Muharam1,2,3, Yuannita Ika Putri1, Muhammad Ikhsan1
1Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Background:
Obese or lean patients with polycystic ovarian syndrome (PCOS) may respond differently to in vitro fertilization (IVF) treatment. The purpose of our study was to compare ovarian response as well as IVF outcomes in lean and obese PCOS patients. The evaluation specifically focused on the utilization of recombinant follicle-stimulating hormone (rFSH) for ovarian stimulation.
Materials And Methods:
This cross-sectional study recruited patients diagnosed with PCOS (according to Rotterdam criteria) undergoing IVF utilizing the gonadotropin-releasing hormone (GnRH) antagonist combined with rFSH protocol. The PCOS patients were grouped into lean PCOS [body mass index (BMI) < 23 kg/m2] and obese PCOS (BMI > 25 kg/m2). Data were obtained from our comprehensive database. This study included a total of 226 women diagnosed with PCOS, who underwent IVF between 2013 and 2023 at our fertility clinics. Women with alternative reproductive endocrinology disorders, frozen embryo cycles, canceled cycles, or those who failed to follow-up were excluded. Each of the lean and obese PCOS groups had 113 patients.
Results:
The mean age of the subjects was 32.7 ± 3.6 years. We found significant differences between the two groups in terms of the anti-müllerian hormone (AMH) levels (P=0.005), the initial dosage of rFSH (P<0.001), and cumulative doses of rFSH administered (P<0.001). However, the number of retrieved oocytes, endometrial thickness, cleavage rate, and pregnancy rates were comparable. Compared to the obese PCOS patients, the lean patients had higher AMH levels (8.80 vs. 6.85 ng/mL) and lower total dosages of rFSH (2128 ± 586 vs. 2752 ± 1136 IU).
Conclusion:
Individuals within the lean PCOS group exhibited elevated AMH levels and demonstrated a more favorable response to rFSH stimulation. Consequently, the lean PCOS group yielded more retrieved oocytes, while necessitating lower doses of rFSH stimulation compared to the obese PCOS group.
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