Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-23T00:31:59.643Z Has data issue: false hasContentIssue false

47A - Asymptomatic Polycystic Ultrasound Appearance of the Ovary Is Favourable for IVF Outcome

For

from Section IX - Hormones and the Environment

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
Get access

Summary

The significant advances in ultrasound technology have resulted in an increase in the prevalence of PCO morphological ultrasonographic criteria diagnosis. These patients have a live birth rate after undergoing up to three cycles of IVF treatment that is 82% higher than women with normal ovaries, requiring fewer ampules of gonadotrophins, producing more follicles and viable oocytes with similar fertilisation and miscarriage rates. Since these women exhibit an exaggerated response to gonadotrophin therapy regardless of COH protocol, the risk remains the increased prevalence of OHSS. Since no COH protocol is superior to manage these patients, protocols that trigger oocyte maturation with a GnRH agonist, with or without a ‘freeze-all’ approach, should be encouraged. Therefore, it is important that every patient undergoing IVF has a baseline ultrasound scan, antral follicle count and AMH levels as well as an assessment of ovarian morphology prior to ART treatments in order to assess risk and reduce complications.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Catteau-Jonard, S, Bancquart, J, Poncelet, E, Lefebvre-Maunoury, C, Robin, G, Dewailly, D. Polycystic ovaries at ultrasound: normal variant or silent polycystic ovary syndrome? Ultrasound Obstet Gynecol. 2012 Aug;40(2):223–9.CrossRefGoogle ScholarPubMed
Mizrachi, Y, Horowitz, E, Farhi, J, Raziel, A, Weissman, A. Ovarian stimulation for freeze-all IVF cycles: a systematic review. Hum Reprod Update. 2020 Jan 1;26(1):118–35.CrossRefGoogle ScholarPubMed
Engmann, L, Sladkevicius, P, Agrawal, R, et al. The pattern of changes in ovarian stromal and uterine artery blood flow velocities during IVF treatment and its relationship with outcome of the cycle. Ultrasound Obstet Gynecol. 1999 Jan;13(1):2633.CrossRefGoogle ScholarPubMed
Kim, YJ, Ku, SY, Jee, BC, 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. 2010 Aug;282(2):199205.CrossRefGoogle ScholarPubMed
Engmann, L, Maconochie, N, Sladkevicius, P, Bekir, J, Campbell, S, Tan, SL. The outcome of in-vitro fertilization treatment in women with sonographic evidence of polycystic ovarian morphology. Hum Reprod. 1999 Jan;14(1):167–71.CrossRefGoogle ScholarPubMed
Selçuk, S, Özkaya, E, Eser, A, et al. Characteristics and outcomes of in vitro fertilization in different phenotypes of polycystic ovary syndrome. Turk J Obstet Gynecol. 2016 March; 13(1):16.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×