Effects of polycystic ovarian syndrome on in vitro fertilization–embryo transfer outcomes are influenced by body mass index

ObjectiveTo determine whether polycystic ovary syndrome (PCOS) adversely impacts IVF–embryo transfer outcomes in obese compared to lean patients.DesignRetrospective chart review.SettingUniversity-affiliated infertility program.Patient(s)Lean non-PCOS (n = 52), lean PCOS (n = 6), obese non-PCOS (n = 18), and obese PCOS (n = 10).Intervention(s)Ninety-four fresh nondonor IVF–embryo transfer cycles analyzed.Main Outcome Measure(s)Cycle characteristics, clinical pregnancy (PR) and live birth rates.Result(s)Lean PCOS had more dominant follicles (12.2 ± 6.0 vs. 7.7 ± 3.6), retrieved oocytes (22.2 ± 9.2 vs. 12.6 ± 5.8), and frozen embryos (5 ± 4.6 vs. 1.4 ± 2.6) than lean non-PCOS. Lean PCOS also used fewer gonadotropin ampules (18.8 ± 6.0 vs. 29.2 ± 14.2), but had more retrieved oocytes (22.2 ± 9.2 vs.14.3 ± 4.9) than obese PCOS. Obese non-PCOS had better-grade embryos (2.1 ± 0.8 vs. 2.7 ± 0.8) and fewer embryos transferred (2.4 ± 0.6 vs. 2.9 ± 0.6) than obese PCOS, but more embryos frozen than lean non-PCOS (3.2 ± 3.2 vs. 1.4 ± 2.6). Implantation rates trended downward in obese patients with PCOS, but no other differences were observed.Conclusion(s)Patients with PCOS with a body mass index (BMI) in the lean rather than the obese range have more favorable assisted reproductive technology (ART) cycle characteristics but show no clinical outcome differences.