Improved implantation and ongoing pregnancy rates after single-embryo transfer with an optimized protocol for in vitro oocyte maturation in women with polycystic ovaries and polycystic ovary syndrome

ObjectiveTo describe an optimized protocol for oocyte in vitro maturation (IVM) that achieves improved implantation and ongoing pregnancy rates in women with polycystic ovaries (PCO) and polycystic ovary syndrome (PCOS).DesignProspective cohort study.SettingHospital fertility unit.Patient(s)Women with PCO and PCOS undergoing treatment for infertility.Intervention(s)Follicle-stimulating hormone (FSH) priming, IVM, blastocyst culture, hormone replacement therapy.Main Outcome Measure(s)Clinical pregnancy rates.Result(s)Our optimized IVM protocol achieves implantation and ongoing pregnancy rates comparable to in vitro fertilization. From 66 oocyte collections, 844 oocytes were collected (12.8 oocytes/cycle), 588 oocytes matured after IVM (69.7% maturation rate), 420 oocytes fertilized after ICSI (71.4% fertilization rate), and 175 blastocyst-stage embryos resulted (41.7% blastocyst-development rate). Of these, 62 blastocyst-stage embryos were transferred as single embryos, resulting in 29 clinical pregnancies (43.9%/oocyte collection, 46.7%/embryo transfer) and 28 live births (42.4%/oocyte collection, 45.2%/embryo transfer).Conclusion(s)In women with PCO or PCOS, improved implantation, clinical pregnancy, and live-birth rates can be achieved after single-embryo transfer by the use of an optimized IVM protocol.