Follicular aspiration during the selection phase prevents severe ovarian hyperstimulation in patients with polycystic ovary syndrome who are undergoing in vitro fertilization.
OBJECTIVE
The objective was to assess the effectiveness of follicular aspiration in the selection phase of infertile women with polycystic ovary syndrome (PCOS) under controlled ovarian hyperstimulation (COH).


METHODS
In group A, 13 infertile patients with PCOS failed at previous IVF or intracytoplasmic sperm injection (ICSI) treatment due to ovarian hyperstimulation syndrome (OHSS; a total of 13 cycles). In group B, new IVF cycles with ultrasound-guided transvaginal follicular aspirations during the selection phase (a total of 13 cycles) were conducted using the same patients. No more than ten follicles remained in bilateral ovaries. Parameters monitored included ovarian size, number of dominant follicles, estradiol (E2) level on the day of human chorionic gonadotrophin (HCG) injection, maturation of oocytes, fertilization rate, cleavage rate, embryo implantation rate, pregnancy rate, and level of serum hormone.


RESULTS
In group B, the average number of follicles>or=12 mm and average serum E2 level were 15.5+/-4.0 and 9899+/-1430 pmol/l, respectively, which were significantly lower than 29.1+/-8.4 (P<0.001) and 15,544+/-1766 pmol/l (P<0.001) in group A. No cycles with moderate or severe OHSS occurred in group B, while nine out of 13 (69.2%) cycles did have this problem in group A. Oocyte maturation rate, fertilization rate and cleavage rate in group B were 80.7%, 76.9%, and 80.3%, respectively; and all of them are significantly higher than 56.4% (P<0.01), 58.7% (P<0.01), and 70.2% (P<0.02) respectively in group A.


CONCLUSIONS
Follicular aspiration during the selection phase can prevent severe OHSS and reduce OHSS prevalence in patients with PCOS undergoing COH.
Zhu
Wen-Jie
WJ
Department of Reproductive Health, ShenZhen City Maternity and Child Healthcare Hospital, No. 2004, Hongli Road, ShenZhen 518028, Guangdong Province, China. zhuwenjie542004@yahoo.com.cn
Li
Xue-Mei
XM
Chen
Xiu-Min
XM
Zhang
Li
L
D000328:Adult; D001707:Biopsy, Needle; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female; D006080:Ovarian Follicle / Q000473:pathology*; D016471:Ovarian Hyperstimulation Syndrome / Q000473:pathology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome; D011247:Pregnancy; D011256:Pregnancy Outcome; D012720:Severity of Illness Index