title: In Vitro Maturation in Women with vs. without Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To evaluate in vitro maturation (IVM) in sub-fertile women with polycystic ovarian syndrome (PCOS) undergoing in vitro fertilisation (IVF), by comparing outcomes with a control group of non-PCOS.
  
  
  METHODS
  A search strategy was developed for PubMed and studies reporting rates of the following outcomes (live birth; clinical pregnancy; implantation; cycle cancellation; oocyte maturation; oocyte fertilization; miscarriage) between patients with PCOS, PCO and controls undergoing IVM were deemed eligible. The review was conducted in accordance to the PRISMA guidelines and included studies quality was assessed through the Newcastle-Ottawa Quality scale. ORs with their corresponding 95% CIs were calculated for the main analysis and subgroup analyses were performed for PCOS cases vs. controls and PCOS vs. PCO cases. Alternative analyses were performed for live birth and clinical pregnancy, based on cycles and on women. Subgroup analyses for FSH stimulation, hCG priming and type of procedure (IVF/ICSI) were undertaken for all meta-analyses encompassing at least four study arms. Random effects models were used to calculate pooled effect estimates.
  
  
  RESULTS
  Eleven studies were identified. A total of 268 PCOS patients (328 cycles), 100 PCO patients (110 cycles) and 440 controls (480 cycles) were included in the meta-analysis. A borderline trend towards higher birth rates among PCOS patients emerged (pooled OR = 1.74, 95%CI: 0.99-3.04) mainly reflected at the subgroup analysis vs. controls. Clinical pregnancy (pooled OR = 2.37, 95%CI: 1.53-3.68) and implantation rates (pooled OR = 1.73, 95%CI: 1.06-2.81) were higher, while cancellation rates lower (pooled OR = 0.18, 95%CI: 0.06-0.47) among PCOS vs. non-PCOS subjects; maturation and miscarriage rates did not differ between groups, while a borderline trend towards lower fertilization rates among PCOS patients was observed.
  
  
  CONCLUSIONS
  The present meta-analysis provides preliminary evidence on the effectiveness of IVM as a treatment option when offered in sub-fertile PCOS women, as the latter present at least as high outcome rates as those in non-PCOS.
authors.affiliation: Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Siristatidis
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors.forename: Theodoros N
authors.initials: TN
authors.lastname: Sergentanis
authors.affiliation: Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Vogiatzi
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors.forename: Prodromos
authors.initials: P
authors.lastname: Kanavidis
authors.affiliation: 3rd Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Chrelias
authors.affiliation: 3rd Department of Obstetrics and Gynecology, University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.
authors.forename: Theodora
authors.initials: T
authors.lastname: Psaltopoulou
mesh_terms: D001723:Birth Rate; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D059471:In Vitro Oocyte Maturation Techniques / Q000379:methods*; D007247:Infertility, Female / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate