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In Vitro Fertilization in Polycystic Ovary Syndrome

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Polycystic Ovary Syndrome

Part of the book series: Serono Symposia USA ((SERONOSYMP))

Abstract

In vitro fertilizationn (IVF) is not the first-line treatment for patients with polycystic ovary syndrome (PCOS). However, because many patients with this condition may have other accompanying infertility factors or because they may fail to conceive despite the generation of ovulatory cycles, IVF may become a consideration. It is therefore incumbent upon physicians involved in advanced reproductive technologies to be aware of the pathophysiology of the PCOS, the specific challenges that the PCOS patient presents during controlled ovarian hyperstimulation for IVF, and an approach to treatment that results in satisfactory pregnancy rates while limiting adverse effects, such as the overian hyperstimulation syndrome (OHSS).

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References

  1. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935; 29: 181–91.

    Google Scholar 

  2. Adams J, Poison DW, Abdulwahid N, Morris DV, Franks S, Mason HD, Tucker M, Price J, Jacobs HS. Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotropin releasing hormone. Lancet 1985; 2: 1375–8.

    Article  PubMed  CAS  Google Scholar 

  3. Conway GS, Honour JW, Jacobs HS. Heterogeneity of the polycystic ovary syndrome: clinical, endocrine and ultrasound features in 556 patients. Clin Endocrinol 1989; 30: 459–70.

    Article  CAS  Google Scholar 

  4. Dor J, Itzkowic DJ, Mashiach S, Lunenfeld B, Serr DM. Cumulative conception rates following gonadotropin therapy. Am J Obstet Gynecol 1980; 136: 102–5.

    PubMed  CAS  Google Scholar 

  5. Buttram V, Vaquero C. Post-ovarian wedge resection adhesive disease. Fertil Steril 1975; 26: 874–6.

    PubMed  Google Scholar 

  6. Smitz J, Camus M, Devroey P, Erard P, Wisanto A, Van Steirteghem AC. Incidence of severe ovarian hyperstimulation syndrome after gonadotrophin releasing hormone agonist/HMG superovulation for in-vitro fertilization. Hum Reprod 1990; 5: 933–7.

    PubMed  CAS  Google Scholar 

  7. Dor J, Shulman A, Levran D, Ben-Rafael Z, Rudak E, Mashiach S. The treatment of patients with polycystic ovary syndrome by in-vitro fertilization: a comparison of results with those patients with tubal infertility. Hum Reprod 1990; 5: 816–8.

    PubMed  CAS  Google Scholar 

  8. Polan ML, Daniele A, Russelm JB, DeCherney AH. Ovulation induction with human menopausal gonadotropin compared to human urinary follicle-stimulating hormone results in a significant shift in follicular fluid andogen levels without discernible differences in granulosa-luteal cell function. J Clin Endocrinol Metab 1986; 63: 1284–91.

    Article  PubMed  CAS  Google Scholar 

  9. Stanger JD, Yovich JL. Reduced in-vitro fertilization of human oocyte from patients with raised basal luteinizing homone levels during the follicular phase. Br J Obstet Gynaecol 1985; 92: 385–93.

    Article  PubMed  CAS  Google Scholar 

  10. Howles CM, Macnamee MC, Edwards RG. Follicular development and early luteal function of conception and non-conception cycles after human in-vitro fertilization: endocrine correlates. Hum Reprod 1987; 2: 17–21.

    PubMed  CAS  Google Scholar 

  11. Tyler J, Collins W. The effect of progesterone and estradiol on gonadotrophininduced oocyte maturation in isolated ovarian follicles from mice. Gamete Res 1980; 3: 59–64.

    Article  CAS  Google Scholar 

  12. Tyler J, Moore-Smith D, Biggers J. Effect of steroids on oocyte maturation and atresia in mouse ovarian fragments in vitro. J Reprod Fertil 1980; 58: 203–12.

    Article  PubMed  CAS  Google Scholar 

  13. Moor RM, Polge C, Willadsen S. Effects of follicular steroids on the maturation and fertilization of mammalian oocytes. J Exp Embryol Morphol 1980; 56: 319–35.

    CAS  Google Scholar 

  14. Sagle M, Bishop K, Alexander FM, Michel M, Bonney RC, Beard RW, Franks S. Recurrent early miscarriage and polycystic ovaries. Br Med J 1988; 297: 1027–8.

    Article  CAS  Google Scholar 

  15. Regan L, Owen EJ, Jacobs HS. Hypersecretion of luteinizing hormone, infertility and miscarriage. Lancet 1990; 336: 1141–4.

    Article  PubMed  CAS  Google Scholar 

  16. Yovich JL. Treatments to enhance implantation. In: Chapman MG, Grudzinskas JG, Chard T, eds. Implantation-biological and clinical aspects. New York: Springer-Verlag, 1988: 239–54.

    Google Scholar 

  17. Adashi EY. Clomiphene citrate: mechanism(s) and site(s) of action-a hypothesis revisited. Fertil Steril 1984; 42: 331–44.

    PubMed  CAS  Google Scholar 

  18. Garcia JI, Jones GS, Wentz AC. The use of clomiphene citrate. Fertil Steril 1977; 28: 707–17.

    PubMed  CAS  Google Scholar 

  19. Hammond MG. Monitoring techniques for improving pregnancy rates during clomiphene ovulation induction. Fertil Steril 1984; 42: 499–509.

    PubMed  CAS  Google Scholar 

  20. Lobo RA, Gysler, March CM, Goebelsmann U, Mishell DR Jr. Clinical and laboratory predictors of clomiphene response. Fertil Steril 1982; 37: 168–74.

    PubMed  CAS  Google Scholar 

  21. March CM. Improved pregnancy rate with monitoring of gonadotropin therapy by three modalities. Am J Obstet Gynecol 1987; 156: 1473–9.

    PubMed  CAS  Google Scholar 

  22. Garcea N, Campo S, Panetta V, Venneri M, Siccardi P, Dargenio R, De Tomasi R. Induction of ovulation with purified follicle-stimulating hormone in patients with polycystic ovarian syndrome. Am J Obstet Gynecol 1985; 151: 635–40.

    PubMed  CAS  Google Scholar 

  23. Larsen T, Larsen JF, Schioler V, Bostofte E, Felding C. Comparison of urinary human follicle-stimulating hormone and human menopausal gonadotropin for ovarian stimulation in polycystic ovarian syndrome. Fertil Steril 1990; 53: 426–31.

    PubMed  CAS  Google Scholar 

  24. Hoffman DI, Lobo RA, Campeau JD, Hsai H-M, Homberg EA, Ono T, Frederick JJ, Platt LD, deZerega GS. Ovulation induction in clomipheneresistant anovulatory women: differential follicular response to purified urinary follicle-stimulating hormone (FSH) versus purified urinary FSH and luteinizing hormone. J Clin Endocrinol Metab 1985: 60: 922–7.

    Article  PubMed  CAS  Google Scholar 

  25. Venturoli S, Paradisi R, Fabbri R, Magrini O, Porcu E, Flamigni C. Comparison between human urinary follicle-stimulating hormone and human menopausal gonadotropin treatment in polycystic ovary. Obstet Gynecol 1984; 63: 6–11.

    PubMed  CAS  Google Scholar 

  26. Tanbo T, Dale PO, Kjekshus E, Haug E, Abyhohm T. Stimulation with human menopausal gonadotropin versus follicle-stimulating hormone after pituitary suppression in polycystic ovarian syndrome. Fertil Steril 1990; 53: 798–803.

    PubMed  CAS  Google Scholar 

  27. Fleming R, Haxton MJ, Hamilton MPR, McCune GS, Black WP, MacNaughton MC, Coutts JRT. Successful treatment of infertile women with oligomenorrhea using a combination of a LHRH agonist and exogeneous gonadotropins. Br J Obstet Gynaecol 1985; 92: 369–73.

    Article  PubMed  CAS  Google Scholar 

  28. Homburg R, Eshel A, Kilborn J, Adams J, Jacobs HS. Combined luteinizing hormone releasing hormone analogue and exogeneous gonadotrophins for the treatment of infertility associated with polycystic ovaries. Hum Reprod 1990; 5: 32–5.

    PubMed  CAS  Google Scholar 

  29. Lanzone A, Fulghesu AM, Spina MA, Apa R, Menini E, Caruso A, Mancuso S. Successful induction of ovulation and conception with combined gonadotropinreleasing hormone agonist plus highly purified follicle stimulating hormone in patients with polycystic ovarian disease. J Clin Endocrinol Metab 1987; 65: 1253–8.

    Article  PubMed  CAS  Google Scholar 

  30. Bernstein J, Seibel MM. New reproductive technologies and polycystic ovary syndrome. Infertil Reprod Med Clin North Am 1991; 2: 585–98.

    Google Scholar 

  31. Hamuri M, Zwirner M, Cledon P, Tinneberg H-R. Androgen response in polycystic ovarian syndrome to FSH treatment after LHRH agonist suppression. Int J Fertil 1992; 37: 171–5.

    Google Scholar 

  32. Chang RJ, Laufer LR, Meldrum DR, DeFazio J, Lu JKH, Vake WW, Rivier JE, Judd HL. Steroid secretion in polycystic ovarian disease after ovarian suppression by a long-acting gonadotropin-releasing hormone agonist. J Clin Endocrinol Metab 1983; 56: 897–903.

    Article  PubMed  CAS  Google Scholar 

  33. Radwanska E, Rawlins RG, Tummon I, Maclin V, Binor Z, Dmowski WP. Successful use of gonadotropin-releasing hormone agonist leuprolide for in vitro fertilization in a patient with polycystic ovarian disease and infertility unresponsive to standard treatment. Fertil Steril 1988; 49: 356–9.

    PubMed  CAS  Google Scholar 

  34. Ashkenazi J, Feldberg D, Dicker D, Yeshaya A, Ayalon D, Goldman JA. IVFET in women with refractory polycystic ovary disease. Eur J Obstet Gynecol Reprod Biol 1989; 30: 157–61.

    Article  PubMed  CAS  Google Scholar 

  35. Salat-Baroux J, Alvarez S, Antoine JM, Tibi C, Cornet D, Plachot M, Mandelbaum J. Results of in-vitro fertilization in the treatment of polycystic ovary disese. Hum Reprod 1988; 3: 331–5.

    PubMed  CAS  Google Scholar 

  36. Salat-Baroux J, Alvarez S, Antoine JM, Tibi C, Cornet D, Mandelbaum J, Plachot M, Junca AM. Comparison between long and short protocols of LHRH agonist in the treatment of polycystic ovary disease by in-vitro fertlization. Hum Reprod 1988; 3: 535–9.

    PubMed  CAS  Google Scholar 

  37. Dale PO, Tanbo T, Abyholm T. In-vitro fertilization in infertile women with the polycystic ovarian syndrome. Hum Reprod 1991; 6: 238–41.

    PubMed  CAS  Google Scholar 

  38. Urman B, Fluker MR, Ho Yuen B, Fleige-Zahradka BG, Zouves CG, Moon YS. The outcome of in vitro fertilization and embryo transfer in women with polycystic ovary syndrome failing to conceive after ovulation induction with exogenous gonadotropins. Fertil Steril 1992; 57: 1269–73.

    PubMed  CAS  Google Scholar 

  39. Homburg R, Berkowitz D, Levy T, Feldberg D, Ashkenazi J, Ben-Rafael Z. In vitro fertilization and embryo transfer for the treatment of infertility associaisted with the polycystic ovarian syndrome. Fertil Steril 1993; 60: 858–63.

    PubMed  CAS  Google Scholar 

  40. Tsafriri A, Lieberman ME, Barnea A, Bauminger S, Lindner HR. Induction by luteinizing hormone of ovum maturation and of sterodiogenesis in isolated Graafian follicles of the rat: role of RNA and of protein synthesis. Endocrinology 1973; 93: 1378–86.

    Article  PubMed  CAS  Google Scholar 

  41. Tanbo T, Abyholm T, Magnus O, Henriksen T. Gonadotropin and ovarian steroid production in polycystic ovarian syndrome during suppression with a gonadotropin-releasing hormone agonist. Gynecol Obstet Invest 1989; 28: 147–51.

    Article  PubMed  CAS  Google Scholar 

  42. Neal GS, Sultan KM, Liu H-C, Davis OK, Rosenwaks Z. A dual approach to ovarian suppression using oral contraceptive pills and leuprolide acetate in high responder patients undergoing IVF. Presented at the Conjoint Meeting of The American Fertility Society and The Canadian Fertility and Andrology Society, Montreal, CA, October 11–14, 1993, abstr P-065.

    Google Scholar 

  43. Navot D, Bergh PA, Laufer N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992; 58: 249–61.

    PubMed  CAS  Google Scholar 

  44. MacDougall MJU, Balen AH, Jacobs HS. Polycystic ovaries and their relevance to assisted fertility. In: Brinsden PR, Rainsbury PA, eds. A textbook of in vitro fertilization and assisted reproduction. Lancaster, UK: Parthenon, 1992: 93–110.

    Google Scholar 

  45. Golan A, Ron-El R, Herman A, Soffer Y, Weinraub, Caspi E. Ovarian hyper-stimulation syndrome: an update review. Obstet Gynecol Sury 1989; 44: 430–40.

    Article  CAS  Google Scholar 

  46. Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY, Yoon TK. Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril 1991; 55: 109–13.

    PubMed  CAS  Google Scholar 

  47. Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril 1994; 62: 353–62.

    PubMed  CAS  Google Scholar 

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© 1996 Springer-Verlag New York, Inc.

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Rosenwaks, Z., Davis, O.K., Damario, M.A. (1996). In Vitro Fertilization in Polycystic Ovary Syndrome. In: Chang, R.J. (eds) Polycystic Ovary Syndrome. Serono Symposia USA. Springer, New York, NY. https://doi.org/10.1007/978-1-4613-8483-0_20

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  • DOI: https://doi.org/10.1007/978-1-4613-8483-0_20

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4613-8485-4

  • Online ISBN: 978-1-4613-8483-0

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