In vitro maturation in sub fertile women with polycystic ovarian syndrome undergoing assisted reproduction.
BACKGROUND
Polycystic ovarian syndrome (PCOS) occurs in 4% to 7% of all women of reproductive age and 20% of women presenting with sub-fertility. A significant proportion of these women will ultimately need assisted reproductive techniques (ART). In women with PCOS, the supra-physiological doses of gonadotrophins used for controlled ovarian hyperstimulation (COH) often result in an exaggerated ovarian response characterised by the development of a large cohort of follicles of uneven quality, retrieval of immature oocytes, and increased risk of ovarian hyperstimulation syndrome. A potentially useful intervention for women with PCOS-related infertility involves earlier retrieval of immature oocytes followed by in vitro maturation (IVM).


OBJECTIVE
To compare live birth rates per woman following in vitro maturation (IVM) with conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) for women with PCOS undergoing ART.


METHODS
We searched the Menstrual Disorders and Subfertility Group Specialised Register of controlled trials for any relevant trials from the title, abstract, or keyword sections. Following a search of electronic databases (MEDLINE in all languages) using Ovid software we also performed a manual search of the references of all retrieved articles, sought unpublished papers and abstracts submitted to international conferences, and contacted experts. In addition, we searched the National Institute of Clinical Excellence fertility assessment and treatment guidelines (NICE 2004) and handsearched reference lists of relevant systematic reviews and randomised trials.


METHODS
All randomised trials on the intention to perform IVM before IVF or ICSI and conventional IVF or ICSI for sub-fertile women with PCOS.


METHODS
We identified no studies that met the inclusion criteria.


RESULTS
There were no trials suitable for inclusion in the review.


CONCLUSIONS
There are no randomised controlled trials upon which to base any practice recommendations regarding IVM before IVF or ICSI for women with PCOS. There is an urgent need for randomised trials in this field.
Siristatidis
Charalambos S
CS
Department of Obstetrics & Gynaecology, University of Aberdeen, Assisted Reproduction Unit, Aberdeen Maternity Hospital, Forest Hill, Aberdeen, UK, AB25 2ZD. harrysiri@hotmail.com
Maheshwari
Abha
A
Bhattacharya
Siladitya
S
D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D066298:In Vitro Techniques; D007247:Infertility, Female / Q000209:etiology; D054315:Oocyte Retrieval / Q000379:methods*; D009865:Oocytes / Q000502:physiology*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D020554:Sperm Injections, Intracytoplasmic