International Journal of Reproductive BioMedicine

Published date: Apr 26 2025

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 23, Issue No. 2

Pages: 207 – 216

DOI: 10.18502/ijrm.v23i2.18496

Mufeda Ali Jwaddr.mufedaali@st.nahrainuniv.edu.iqDepartment of Physiology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad

Maryam Hussein KhaleefahDepartment of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad

Ramih Abd AlFattah NaserDepartment of Applied Embryology, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad

Background: Polycystic ovarian syndrome (PCOS) is a complex disorder that affects the endocrine, metabolic, and reproductive systems. While controlled ovarian hyperstimulation can increase the number of oocytes retrieved and improve the number of good-quality embryos, it may also negatively affect oocyte maturity, embryo quality, endometrial receptivity, and pregnancy outcomes.

Objective: This study aimed to find out if ovarian hyperstimulation syndrome (OHSS) has negative effects on intracytoplasmic sperm injection outcomes in a sample of PCOS women.

Materials and Methods: In this cross-sectional study, data of 84 PCOS women who underwent controlled ovarian stimulation using a flexible antagonist protocol-treated intracytoplasmic sperm injection cycles referred to the Infertility Department of Higher Institute for the Diagnosis of Infertility and Assisted Reproduction Techniques, Baghdad, Iraq between January 2020 and December 2023 was extracted from their medical records. Participants were categorized into 2 groups after undergoing controlled ovarian hyperstimulation protocol: PCOS with OHSS (n = 54) and PCOS without OHSS (n = 30). The dosage was tailored based on age, body mass index, and response to previous stimulation cycles, if applicable. The trigger was administered using decapeptyl 0.2 mg alone or in combination with recombinant human chorionic gonadotrophin, depending on the estradiol levels at the time of the trigger.

Results: Significant differences were observed in the duration of stimulation (p = 0.005), oocyte yield (p = 0.001), mature oocytes (p = 0.001), and fertilized oocytes (p = 0.036); however, no significant difference was observed, neither in number of good quality embryos (p = 0.52) nor in pregnancy rate (p = 0.54) after fresh and frozen embryo transfer between the 2 groups.

Conclusion: OHSS does not affect the embryo quality or pregnancy rate in PCOS women.

Keywords: Polycystic ovary syndrome, Ovarian hyperstimulation syndrome, Intracytoplasmic sperm injection, Ovulation induction

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