Assisted reproductive technology in late reproductive age women with polycystic ovarian syndrome


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Abstract

Objective: To compare the efficiency of frozen-thawed embryo transfer after preimplantation genetic testing for aneuploidy (PGT-A) in late reproductive age women with polycystic ovarian syndrome (PCOS) and those with tubal-peritoneal factor infertility. Materials and methods: The study included 63 infertile women of late reproductive age undergoing IVF/ICSI with gonadotropin-releasing hormone (GnRH) antagonists followed by PGT-A. The patients were divided into Group 1 including women with tubal-peritoneal infertility (n=30) and Group 2 including women with PCOS (n=33). Then, all the patients included in this study underwent frozen-thawed embryo transfer, providing the availability of embryos recommended for transfer by genetic testing. The effectiveness of the ART program was evaluated by the rates of achieved pregnancy, biochemical pregnancy rate, ectopic pregnancy rate, spontaneous miscarriage rate, missed miscarriage rate, and live birth rates. Results: There were no differences in IVF/ICSI efficacy between the two study groups. A total of9/27 (33.3%) pregnancies were recorded in the tubal-peritoneal factor group versus 8/25 (32%) in the PCOS group (p=0.919), a difference that was not statistically significant [OR 1.042 (CI0.48; 2.28), p=0.919]. Of them, 5/27 (18.5%) and 4/25 (16%) ended in birth [OR 1.157 (CI 0.35; 3.83), p=0.811] and 6/27(22.2%) and 4/25 (16%) resulted in miscarriage [OR 1.39 (CI 0.44; 4.35), p=0.569]. There was only one miscarriage (3.7%) in the group of patients with tubal-peritoneal infertility factor. Conclusion: In late reproductive age, patients with both PCOS and tubal-peritoneal infertility factor, IVF/ICSI and PGT-A programs followed by frozen-thawed embryo transfer demonstrated similar efficacy. Despite the higher ovarian reserve, the efficacy of ART programs in patients with PCOS also decreases with age, requiring PGT-A in older patients, regardless of the infertility factor. Further studies of this problem on a larger sample of patients are needed.

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About the authors

Nina D. Mikhailova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: mihailnina@mail.ru
PhD. Student at the lst Gynecology Department

Artem A. Aksenenko

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_axenenko@oparina4.ru
Gynecologist at the lst Gynecology Department

Evelina R. Durinyan

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: e_durinyan@oparina4.ru
Ph.D., Clinical Care Supervisor at the lst Gynecological Department

Alla A. Gavisova

V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: gavialla@yandex.ru
Ph.D., Senior Researcher at the lst Gynecological Department.

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