Assisted conception using buserelin and human menopausal gonadotrophins in women with polycystic ovary syndrome.
OBJECTIVE
To compare the outcome of in vitro fertilisation (IVF) and gamete intrafallopian transfer (GIFT) cycles in women with or without ultrasound features of polycystic ovary syndrome (PCOS).


METHODS
A consecutive series from January to December 1989.


METHODS
Twenty-five women with PCOS scheduled for assisted conception. The controls were 139 women with normal ovaries.


METHODS
A single centre specialist fertility unit, Manchester, UK.


METHODS
Pituitary desensitisation was with buserelin. In the PCOS group ovarian stimulation was with 1 ampoule (75 iu FSH) of hMG/day in 12 women (Group I) and two ampoules/day in 13 (Group II). The controls (Group III) were given two ampoules of hMG daily. Human chorionic gonadotrophin (hCG; 10,000 iu) was given when three follicles measured > or = 20 mm diameter.


METHODS
Serum oestradiol (E2) concentrations, number of follicles, clinical pregnancies, features of the ovarian hyperstimulation syndrome (OHS).


RESULTS
Women with PCOS (Groups I or II) had more follicles > or = 14 mm diameter on the day of the hCG injection (P < 0.005), higher serum E2 concentrations on the day after the hCG (P < 0.05) and more oocytes retrieved (P < 0.05) than the controls. The OHS was more prevalent in those with PCOS (32% versus 6.5%; P < 0.05). The clinical pregnancy rate per embryo transfer (27% versus 22%) or gamete transfer (25% versus 39%) and the rate of spontaneous miscarriage (33% versus 12%) were not statistically different.


CONCLUSIONS
The pregnancy rate and outcome of pregnancy following IVF or GIFT in women with or without PCOS are similar. Women with PCOS are at a higher risk of developing OHS.
Wada
I
I
Manchester Fertility Services, BUPA Hospital, Whalley Range, UK.
Matson
P L
PL
Troup
S A
SA
Lieberman
B A
BA
D000328:Adult; D002064:Buserelin / Q000627:therapeutic use*; D006063:Chorionic Gonadotropin / Q000627:therapeutic use*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D015181:Gamete Intrafallopian Transfer; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors
D006063:Chorionic Gonadotropin; D004958:Estradiol; D002064:Buserelin