Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization
Abstract Background The number of oocytes retrieved does not always coincide with the number of follicles aspirated in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Patients with high expectation of retrieval sometimes obtain few oocytes, which may be induced by impro...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-07-01
|
| Series: | Reproductive Biology and Endocrinology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12958-023-01118-1 |
| _version_ | 1797773908650229760 |
|---|---|
| author | Hao Jin Haiyan Yang Jiujia Zheng Jiechun Zhou Rong Yu |
| author_facet | Hao Jin Haiyan Yang Jiujia Zheng Jiechun Zhou Rong Yu |
| author_sort | Hao Jin |
| collection | DOAJ |
| description | Abstract Background The number of oocytes retrieved does not always coincide with the number of follicles aspirated in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Patients with high expectation of retrieval sometimes obtain few oocytes, which may be induced by improper operation or therapeutic factors. The purpose of this study was to evaluate the distribution data of oocyte retrieval rate (ORR) and to explore the risk factors for low ORR in patients with polycystic ovary syndrome (PCOS) undergoing IVF/ICSI. Methods A total of 2478 patients with PCOS undergoing IVF/ICSI were involved in this retrospective case-control study from March 2016 to October 2021. The oocyte retrieval rate was calculated as the ratio of the number of obtained oocytes to the number of follicles (≥ 12 mm) on the trigger day. Patients were divided into a low ORR and a normal ORR group with the boundary of one standard deviation from the mean value of ORR. The patient characteristics, treatment protocols, serum hormone levels, and embryonic and pregnancy outcomes were analyzed. Results The ORR exhibited a non-normal distribution, with a median of 0.818. The incidence of complete empty follicle syndrome was 0.12% (3/2478). The proportion of patients in the low ORR group who received the progestin-primed protocol was significantly higher than that in the normal ORR group (30.30% vs. 17.69%). A logistic regression analysis showed that the serum estradiol level/follicle (≥ 12 mm) ratio (OR: 0.600 (0.545–0.661)) and progesterone level (OR: 0.783 (0.720–0.853)) on the trigger day were significant factors in the development of a low ORR, with optimal cutoff values of 172.85 pg/ml and 0.83 ng/ml, respectively, as determined by receiver operating curve. Fewer high-quality embryos (2 vs. 5) and more cycles with no available embryos (5.42% vs. 0.43%) were found in the low ORR group. Conclusions For patients with PCOS, low estradiol levels/follicles (≥ 12 mm) and progesterone levels on the trigger day and the use of the progestin-primed protocol could be risk factors for low ORR, which leads to a limited number of embryos and more cycle cancellations. |
| first_indexed | 2024-03-12T22:12:25Z |
| format | Article |
| id | doaj.art-c87b75457e6844b29bd40719cb923e81 |
| institution | Directory Open Access Journal |
| issn | 1477-7827 |
| language | English |
| last_indexed | 2024-03-12T22:12:25Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Reproductive Biology and Endocrinology |
| spelling | doaj.art-c87b75457e6844b29bd40719cb923e812023-07-23T11:29:59ZengBMCReproductive Biology and Endocrinology1477-78272023-07-012111910.1186/s12958-023-01118-1Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilizationHao Jin0Haiyan Yang1Jiujia Zheng2Jiechun Zhou3Rong Yu4The Urological Surgical Department, The First Affiliated Hospital of Wenzhou Medical UniversityThe Reproductive Center, the First Affiliated Hospital of Wenzhou Medical UniversityThe Reproductive Center, the First Affiliated Hospital of Wenzhou Medical UniversityThe Reproductive Center, the First Affiliated Hospital of Wenzhou Medical UniversityThe Reproductive Center, the First Affiliated Hospital of Wenzhou Medical UniversityAbstract Background The number of oocytes retrieved does not always coincide with the number of follicles aspirated in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Patients with high expectation of retrieval sometimes obtain few oocytes, which may be induced by improper operation or therapeutic factors. The purpose of this study was to evaluate the distribution data of oocyte retrieval rate (ORR) and to explore the risk factors for low ORR in patients with polycystic ovary syndrome (PCOS) undergoing IVF/ICSI. Methods A total of 2478 patients with PCOS undergoing IVF/ICSI were involved in this retrospective case-control study from March 2016 to October 2021. The oocyte retrieval rate was calculated as the ratio of the number of obtained oocytes to the number of follicles (≥ 12 mm) on the trigger day. Patients were divided into a low ORR and a normal ORR group with the boundary of one standard deviation from the mean value of ORR. The patient characteristics, treatment protocols, serum hormone levels, and embryonic and pregnancy outcomes were analyzed. Results The ORR exhibited a non-normal distribution, with a median of 0.818. The incidence of complete empty follicle syndrome was 0.12% (3/2478). The proportion of patients in the low ORR group who received the progestin-primed protocol was significantly higher than that in the normal ORR group (30.30% vs. 17.69%). A logistic regression analysis showed that the serum estradiol level/follicle (≥ 12 mm) ratio (OR: 0.600 (0.545–0.661)) and progesterone level (OR: 0.783 (0.720–0.853)) on the trigger day were significant factors in the development of a low ORR, with optimal cutoff values of 172.85 pg/ml and 0.83 ng/ml, respectively, as determined by receiver operating curve. Fewer high-quality embryos (2 vs. 5) and more cycles with no available embryos (5.42% vs. 0.43%) were found in the low ORR group. Conclusions For patients with PCOS, low estradiol levels/follicles (≥ 12 mm) and progesterone levels on the trigger day and the use of the progestin-primed protocol could be risk factors for low ORR, which leads to a limited number of embryos and more cycle cancellations.https://doi.org/10.1186/s12958-023-01118-1OocytePolycystic ovary syndromeIn vitro fertilizationRisk factor |
| spellingShingle | Hao Jin Haiyan Yang Jiujia Zheng Jiechun Zhou Rong Yu Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization Reproductive Biology and Endocrinology Oocyte Polycystic ovary syndrome In vitro fertilization Risk factor |
| title | Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| title_full | Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| title_fullStr | Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| title_full_unstemmed | Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| title_short | Risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| title_sort | risk factors for low oocyte retrieval in patients with polycystic ovarian syndrome undergoing in vitro fertilization |
| topic | Oocyte Polycystic ovary syndrome In vitro fertilization Risk factor |
| url | https://doi.org/10.1186/s12958-023-01118-1 |
| work_keys_str_mv | AT haojin riskfactorsforlowoocyteretrievalinpatientswithpolycysticovariansyndromeundergoinginvitrofertilization AT haiyanyang riskfactorsforlowoocyteretrievalinpatientswithpolycysticovariansyndromeundergoinginvitrofertilization AT jiujiazheng riskfactorsforlowoocyteretrievalinpatientswithpolycysticovariansyndromeundergoinginvitrofertilization AT jiechunzhou riskfactorsforlowoocyteretrievalinpatientswithpolycysticovariansyndromeundergoinginvitrofertilization AT rongyu riskfactorsforlowoocyteretrievalinpatientswithpolycysticovariansyndromeundergoinginvitrofertilization |