Among high responders, is oocyte development potential different in Rotterdam consensus PCOS vs non-PCOS patients undergoing IVF?

Purpose To evaluate the oocyte potential to develop to blastocyst in Rotterdam consensus PCOS in women with hyperresponses requiring freeze-all embryos. Methods Retrospective, single-academic center, cohort study of 205 patients who underwent freeze-all antagonist IVF cycles for OHSS risk between 2013 and 2019. Women in the PCOS group (n= 88) were diagnosed per the 2003 Rotterdam criteria. Control patients (n = 122) had no evidence of hyperandrogenism or menstrual disturbance. Data was compared by t-tests, chi-squared tests, or multivariate logistic regression (SPSS). Frozen blastocysts were Gardner's grade BB or better. Results There was no difference in terms of number of oocytes collected (PCOS vs non-PCOS 27.7 +/- 9.4 vs 25.9 +/- 8.2, p = 0.157), number of MII (20.7 +/- 8.0 vs 19.1 +/- 6.6, p =0.130), number of 2PN fertilized (15.6 +/- 7.4 vs 14.4 +/- 5.9, p =0.220), and number of frozen blastocysts (7.8 +/- 4.9 vs 7.1 +/- 3.8, p = 0.272). In addition, fertilization rates (74 +/- 17% vs 75 +/- 17%, p = 0.730), blastulation rates per 2PN (51 +25% vs 51 +25%, p = 0.869), and blastulation rates per mature oocytes (37 +/- 18% vs 37 +/- 15%, p = 0.984) were all comparable between PCOS and controls, respectively. Moreover, there was no difference when comparing PCOS and controls in pregnancy rates (45/81 vs 77/122, p = 0.28) and clinical pregnancy rates (34/81 vs 54/122, p =0.75), respectively. Multivariate logistic regression controlling for confounders failed to alter these results. Conclusion PCOS subjects do not seem to have altered oocyte potential as measured by number of MII oocytes collected, fertilization, and blastulation rates when compared to high-responder controls, with similar magnitude of stimulation.