Lean Polycystic Ovarian Syndrome Has Better Responses toRecombinant Follicle-Stimulating Hormone Compared to ObesePCOS during Ovarian Stimulation for In Vitro Fertilization:A Cross-Sectional Study
نویسندگان
1 Department of Obstetrics & Gynecology, McGill University, Montreal, Quebec, Canada
2 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
3 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
4 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
5 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
6 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
7 Human Reproduction, Fertility and Family Planning Cluster, Indonesia Reproductive Medicine Research and Training Center, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
8 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
9 Yasmin IVF Clinic Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
10 Reproductive Immunoendocrinology Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
11 Human Reproduction, Fertility and Family Planning Cluster, Indonesia Reproductive Medicine Research and Training Center, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia
doi
10.22074/ijfs.2025.2023851.1632چکیده
Background: Obese or lean patients with polycystic ovarian syndrome (PCOS) may respond differently to in vitrofertilization (IVF) treatment. The purpose of our study was to compare ovarian response as well as IVF outcomes inlean and obese PCOS patients. The evaluation specifically focused on the utilization of recombinant follicle-stimulatinghormone (rFSH) for ovarian stimulation.Materials and Methods: This cross-sectional study recruited patients diagnosed with PCOS (according to Rotterdamcriteria) undergoing IVF utilizing the gonadotropin-releasing hormone (GnRH) antagonist combined with rFSHprotocol. The PCOS patients were grouped into lean PCOS [body mass index (BMI) < 23 kg/m2] and obese PCOS(BMI > 25 kg/m2). Data were obtained from our comprehensive database. This study included a total of 226 womendiagnosed with PCOS, who underwent IVF between 2013 and 2023 at our fertility clinics. Women with alternativereproductive endocrinology disorders, frozen embryo cycles, canceled cycles, or those who failed to follow-up wereexcluded. Each of the lean and obese PCOS groups had 113 patients.Results: The mean age of the subjects was 32.7 ± 3.6 years. We found significant differences between the two groupsin terms of the anti-müllerian hormone (AMH) levels (P=0.005), the initial dosage of rFSH (P<0.001), and cumulativedoses of rFSH administered (P<0.001). However, the number of retrieved oocytes, endometrial thickness, cleavagerate, and pregnancy rates were comparable. Compared to the obese PCOS patients, the lean patients had higher AMHlevels (8.80 vs. 6.85 ng/mL) and lower total dosages of rFSH (2128 ± 586 vs. 2752 ± 1136 IU).Conclusion: Individuals within the lean PCOS group exhibited elevated AMH levels and demonstrated a more favorableresponse to rFSH stimulation. Consequently, the lean PCOS group yielded more retrieved oocytes, whilenecessitating lower doses of rFSH stimulation compared to the obese PCOS group.
