Thorough sonographic oocyte retrieval during in vitro fertilization produces results similar to ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.
OBJECTIVE
The purpose of this study was to compare the effectiveness of a thorough sonographic oocyte retrieval to a routine in vitro fertilization retrieval to induce ovulation, pregnancy, and endocrine changes in patients with polycystic ovarian syndrome in their post-in vitro fertilization cycles.


METHODS
Sixty-four patients from a tertiary infertility clinic, with clomiphene citrate-resistant polycystic ovarian syndrome and who were undergoing in vitro fertilization, were assigned randomly into 2 groups. Group 1 (n = 34) had a thorough (every possible follicle punctured) sonographic oocyte retrieval, and group 2 (n = 30) had a routine (only follicles that were likely to contain oocytes) in vitro fertilization retrieval. These patients who did not conceive in their in vitro fertilization cycle were monitored with ultrasound scanning for evidence of ovulation, pregnancy, before and after day 3 gonadotropin, and steroid hormone levels. Analysis of variance and the Student t test were used for statistical significance.


RESULTS
Ovulation rates of 53% (18/34) and cumulative pregnancy rate of 44% (8/18) were observed in group 1, with no ovulations in group 2. Significant decreases in luteinizing hormone/FSH ratio (4.1 to 1.7) and testosterone (1.2 to 0.7 ng/mL) occurred after treatment in the thorough sonographic oocyte retrieval group, with no change after routine in vitro fertilization. Operating time was increased significantly in the thorough sonographic oocyte retrieval group (45 vs 24 minutes) in group 2.


CONCLUSIONS
Thorough sonographic oocyte retrieval during in vitro fertilization cycle can produce significant improvements in the endocrinologic abnormalities, ovulation, and pregnancies that are comparable with ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.
Branigan
Emmett F
EF
Bellingham IVF and Infertility Center, Bellingham, WA, USA.
Estes
Antoinette
A
Walker
Kenneth
K
Rothgeb
Jillian
J
D002996:Clomiphene / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy; D007986:Luteinizing Hormone / Q000097:blood; D009865:Oocytes; D010053:Ovary / Q000000981:diagnostic imaging* / Q000601:surgery; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D013739:Testosterone / Q000097:blood; D020858:Tissue and Organ Harvesting / Q000379:methods; D014463:Ultrasonography
D005300:Fertility Agents, Female; D002996:Clomiphene; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone