Skip to main content
Log in

A comparative study on the outcomes of in vitro fertilization between women with polycystic ovary syndrome and those with sonographic polycystic ovary-only in GnRH antagonist cycles

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript



This study was performed to compare the outcomes of controlled ovarian stimulation (COH) and IVF between women with PCOS and those with sonographic PCO-only in GnRH antagonist cycles.


This was a retrospective study of women with PCOS (n = 42) and those with sonographic PCO-only (n = 54) undergoing IVF. Responses to COH, adverse events such as severe ovarian hyperstimulation syndrome (OHSS), embryological and pregnancy outcomes were compared between the two groups using GnRH antagonist cycles and between GnRH agonist and antagonist protocols in the two groups, respectively.


There were no differences in the duration of stimulation, dose of gonadotropins used, E2 level on hCG day, numbers of retrieved oocytes, and incidence of sever OHSS between PCOS and sonographic PCO-only groups, which was also observed both in GnRH agonist and antagonist subgroups. Pregnancy rates between PCOS and sonographic PCO-only groups in GnRH agonist (21.7 vs. 34.4%, P = 0.238) and antagonist (26.3 vs 22.7%, P = 0.537) subgroups did not differ. In regard to COH regimen, GnRH agonist long protocols showed higher responses than antagonist protocols both in PCOS group [number of retrieved oocytes (13.2 ± 5.8 vs. 8.2 ± 3.2, P < 0.001)] and sonographic PCO-only group [number of retrieved oocytes (13.7 ± 5.2 vs. 9.2 ± 6.7, P = 0.008); E2 level on hCG day (3,005.1 ± 1,317.1 vs. 1,525.9 ± 738.6 pg/mL, P < 0.001)].


Women with PCOS and sonographic PCO-only may have similar outcome during COH cycle for IVF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO (2004) The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 89(6):2745–2749

    Article  CAS  PubMed  Google Scholar 

  2. The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group (2004) Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (pcos). Hum Reprod 19(1):41–47

    Article  Google Scholar 

  3. Carmina E, Chu MC, Longo RA, Rini GB, Lobo RA (2005) Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab 90(5):2545–2549

    Article  CAS  PubMed  Google Scholar 

  4. Balen AH, Laven JS, Tan SL, Dewailly D (2003) Ultrasound assessment of the polycystic ovary: international consensus definitions. Hum Reprod Update 9(6):505–514

    Article  PubMed  Google Scholar 

  5. Michelmore K, Ong K, Mason S, Bennett S, Perry L, Vessey M, Balen A, Dunger D (2001) Clinical features in women with polycystic ovaries: Relationships to insulin sensitivity, insulin gene vntr and birth weight. Clin Endocrinol (Oxf) 55(4):439–446

    Article  CAS  Google Scholar 

  6. Schenker JG (1993) Prevention and treatment of ovarian hyperstimulation. Hum Reprod 8(5):653–659

    CAS  PubMed  Google Scholar 

  7. Hatch R, Rosenfield RL, Kim MH, Tredway D (1981) Hirsutism: implications, etiology, and management. Am J Obstet Gynecol 140(7):815–830

    CAS  PubMed  Google Scholar 

  8. Lee JR, Kim SH, Kim SM, Jee BC, Ku SY, Suh CS, Choi YM, Kim JG, Moon SY (2008) Follicular fluid anti-mullerian hormone and inhibin b concentrations: comparison between gonadotropin-releasing hormone (gnrh) agonist and gnrh antagonist cycles. Fertil Steril 89(4):860–867

    Article  CAS  PubMed  Google Scholar 

  9. Moon SY, Choi YS, Ku SY, Kim SH, Choi YM, Kang IS, Kim CH (2007) Comparison of the efficacy and safety of a new recombinant human follicle-stimulating hormone (da-3801) with follitropin-alpha (Gonal-f) in women undergoing controlled ovarian hyperstimulation for assisted reproductive technology. J Obstet Gynaecol Res 33(3):305–315

    Article  CAS  PubMed  Google Scholar 

  10. Veeck LL (1988) Oocyte assessment and biological performance. Ann NY Acad Sci 541:259–274

    Article  CAS  PubMed  Google Scholar 

  11. The Practice Committee of the American Society for Reproductive Medicine (2004) Ovarian hyperstimulation syndrome. Fertil Steril 82(Suppl 1):S81–S86

    Google Scholar 

  12. Kolibianakis EM, Papanikolaou EG, Tournaye H, Camus M, Van Steirteghem AC, Devroey P (2007) Triggering final oocyte maturation using different doses of human chorionic gonadotropin: a randomized pilot study in patients with polycystic ovary syndrome treated with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone. Fertil Steril 88(5):1382–1388

    Article  CAS  PubMed  Google Scholar 

  13. Lainas TG, Petsas GK, Zorzovilis IZ, Iliadis GS, Lainas GT, Cazlaris HE, Kolibianakis EM (2007) Initiation of gnrh antagonist on day 1 of stimulation as compared to the long agonist protocol in pcos patients. A randomized controlled trial: effect on hormonal levels and follicular development. Hum Reprod 22(6):1540–1546

    Article  CAS  PubMed  Google Scholar 

  14. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J (1999) Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 22(1):141–146

    Article  CAS  PubMed  Google Scholar 

  15. Esmailzadeh S, Faramarzi M, Jorsarai G (2005) Comparison of in vitro fertilization outcome in women with and without sonographic evidence of polycystic ovarian morphology. Eur J Obstet Gynecol Reprod Biol 121(1):67–70

    Article  PubMed  Google Scholar 

  16. Jung JH, Kim SH, Suh CS, Choi YM, Shin CJ, Kim JG, Moon SY, Lee JY (1997) Outcome of in vitro fertilization and embryo transfer in patients with multifollicular ovarian pattern in transvaginal ultrasonography. Korean J Obstet Gynecol 40(5):1002–1012

    Google Scholar 

  17. Esinler I, Bayar U, Bozdag G, Yarali H (2005) Outcome of intracytoplasmic sperm injection in patients with polycystic ovary syndrome or isolated polycystic ovaries. Fertil Steril 84(4):932–937

    Article  PubMed  Google Scholar 

  18. Sahu B, Ozturk O, Ranierri M, Serhal P (2008) Comparison of oocyte quality and intracytoplasmic sperm injection outcome in women with isolated polycystic ovaries or polycystic ovarian syndrome. Arch Gynecol Obstet 277(3):239–244

    Article  PubMed  Google Scholar 

  19. Griesinger G, Diedrich K, Tarlatzis BC, Kolibianakis EM (2006) Gnrh-antagonists in ovarian stimulation for ivf in patients with poor response to gonadotrophins, polycystic ovary syndrome, and risk of ovarian hyperstimulation: a meta-analysis. Reprod Biomed Online 13(5):628–638

    Article  CAS  PubMed  Google Scholar 

  20. Hwang JL, Seow KM, Lin YH, Huang LW, Hsieh BC, Tsai YL, Wu GJ, Huang SC, Chen CY, Chen PH, Tzeng CR (2004) Ovarian stimulation by concomitant administration of cetrorelix acetate and HMG following diane-35 pre-treatment for patients with polycystic ovary syndrome: a prospective randomized study. Hum Reprod 19(9):1993–2000

    Article  CAS  PubMed  Google Scholar 

  21. Bahceci M, Ulug U, Ben-Shlomo I, Erden HF, Akman MA (2005) Use of a gnrh antagonist in controlled ovarian hyperstimulation for assisted conception in women with polycystic ovary disease: a randomized, prospective, pilot study. J Reprod Med 50(2):84–90

    CAS  PubMed  Google Scholar 

  22. Choi JW, Kim CH, Lee HA, Hong SH, Nah HY, Lee YJ, Kim SH, Chae HD, Son YS, Kang BM (2005) Efficacy of controlled ovarian hyperstimulation using gnrh antagonist in women with polycystic ovary syndrome undergoing ivf-et. Korean J Obstet Gynecol 48(3):716–725

    Google Scholar 

  23. Kurzawa R, Ciepiela P, Baczkowski T, Safranow K, Brelik P (2008) Comparison of embryological and clinical outcome in gnrh antagonist vs. Gnrh agonist protocols for in vitro fertilization in pcos non-obese patients. A prospective randomized study. J Assist Reprod Genet 25(8):365–374

    Article  PubMed  Google Scholar 

  24. Orvieto R, Nahum R, Meltcer S, Homburg R, Rabinson J, Anteby EY, Ashkenazi J (2009) Ovarian stimulation in polycystic ovary syndrome patients: the role of body mass index. Reprod Biomed Online 18(3):333–336

    Article  PubMed  Google Scholar 

  25. Cho LW, Jayagopal V, Kilpatrick ES, Holding S, Atkin SL (2006) The LH/FSH ratio has little use in diagnosing polycystic ovarian syndrome. Ann Clin Biochem 43(Pt 3):217–219

    Article  CAS  PubMed  Google Scholar 

  26. Wei HJ, Young R, Kuo IL, Liaw CM, Chiang HS, Yeh CY (2009) Prevalence of insulin resistance and determination of risk factors for glucose intolerance in polycystic ovary syndrome: a cross-sectional study of Chinese infertility patients. Fertil Steril 91(5):1864–1868

    Article  CAS  PubMed  Google Scholar 

  27. Yilmaz N, Pektas M, Tonguc E, Kilic S, Gulerman C, Gungor T, Mollamahmutoglu L (2008) The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. J Obstet Gynaecol Res 34(3):384–391

    Article  CAS  PubMed  Google Scholar 

  28. Sayin NC, Gucer F, Balkanli-Kaplan P, Yuce MA, Ciftci S, Kucuk M, Yardim T (2003) Elevated serum TNF-alpha levels in normal-weight women with polycystic ovaries or the polycystic ovary syndrome. J Reprod Med 48(3):165–170

    CAS  PubMed  Google Scholar 

  29. Adams JM, Taylor AE, Crowley WF Jr, Hall JE (2004) Polycystic ovarian morphology with regular ovulatory cycles: insights into the pathophysiology of polycystic ovarian syndrome. J Clin Endocrinol Metab 89(9):4343–4350

    Article  CAS  PubMed  Google Scholar 

  30. Chae SJ, Kim JJ, Choi YM, Hwang KR, Jee BC, Ku SY, Suh CS, Kim SH, Kim JG, Moon SY (2008) Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Hum Reprod 23(8):1924–1931

    Article  PubMed  Google Scholar 

Download references


The authors would like to express our deepest gratitude to Sun Kyung Oh, Hee Sun Kim, Moon Ju Kang, Sung Ah Kim and Jun Ho Ku for their laboratory and statistical support of this study. This study was supported by a grant of the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (01-PJ10-PG6-01GN13-0002).

Conflict of interest statement


Author information

Authors and Affiliations


Corresponding author

Correspondence to Seung-Yup Ku.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, Y.J., Ku, SY., Jee, B.C. et al. A comparative study on the outcomes of in vitro fertilization between women with polycystic ovary syndrome and those with sonographic polycystic ovary-only in GnRH antagonist cycles. Arch Gynecol Obstet 282, 199–205 (2010).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: