A comparison of IVF outcomes transferring a single ideal blastocyst in women with polycystic ovary syndrome and normal ovulatory controls

Purpose To assess the effects PCOS on live birth rates when transferring a single fresh ideal blastocyst. Methods A retrospective cohort study performed at the university-affiliated reproductive center. Women with PCOS and a control group of normal ovulatory women who underwent their first fresh embryo transfer with single ideal grade blastocyst were included in the study. Demographic, stimulation information and pregnancy outcomes were collected and analysed. The primary outcome was live birth rates, and secondary outcomes included pregnancy and clinical pregnancy rates. Results 71 Women with PCOS and 272 normal ovulatory controls underwent their first embryo transfer and met the inclusion and exclusion criteria. PCOS patient were younger (31.0 +/- 3.7 vs. 33.1 +/- 3.2,p = 0.0001), with higher AFC (40.0 +/- 9.3 vs. 13.3 +/- 4.6,p = 0.0001), required lower dose of gonadotropins to stimulate (1198 +/- 786 vs. 1891 +/- 1224,p = 0.0001), and had higher serum testosterone levels (2.3 +/- 0.7 vs. 1.1 +/- 0.3,p = 0.0001). No significant difference was found between the two groups regarding the number of previous pregnancies, the number of previous full-term pregnancies, the level of basal serum FSH, estradiol level at triggering and the BMI. When compared by Chi squared testing pregnancy rates, clinical pregnancy rates and live birth rates did not differ. However, when controlling (with multivariate stepwise logistic regression) for confounders, live birth rates were lower among the women with PCOS (p = 0.035, CI: 0.18-0.92). Conclusion After controlling for confounders, when transferring a fresh single ideal blastocyst, live birth rates were lower among the women with PCOS than normal ovulatory controls.