Study on clinical effect of different protocols in infertility women with polycystic ovary syndrome undergoing in vitro fertilization-embryo transfer

Objective:To compare clinical and laboratory outcomes of in vitro maturation(IVM),gonadotropin-releasing hormone(GnRH) antagonist protocol,dual suppression protocol using oral contraceptives(OC) GnRH agonist,and early follicular initiation protocol with GnRH agonist in infertile women with polycystic ovary syndrome(PCOS).Methods:A total of 413 infertile patients with PCOS underwent 458 IVF cycles in the First Affiliated Hospital of Wenzhou Medical College from January 2011 to December 2012 and their data were analyzed retrospectively.They were divided into 4 groups according to different protocols,namely IVM group(group A,95 cycles),GnRH antagonist protocol group(group B,53 cycles),OC and GnRH agonist protocol group(group C,278 cycles) and early follicular initiation protocol with GnRH agonist group(group D,32 cycles).The laboratory and clinical results were compared among them.Results:No gonadotropin was used in the group A.The mean dosage of gonadotropin administrated was statistically different between group B and group C,which was(1,297.17±398.88) U and(1,503.9 + 507.63) Urespectively(P0.05).Clinical pregnancy rate per transfer in group A,group B,group C and group D were 33.7%,54.5%,61.1%and 55.2%respectively,which was significantly lower in group A than that of other three groups(P0.05).There were no significant differences among other three groups(P0.05).No ovary hyperstimulation syndrome(OHSS) was found in group A and no severe OHSS was found in group B and group D.Incidence of OHSS in group A,grouo PB,group C and group D were 0%,13.2%,20.7%,and 18.8%respectively.Conclusions:This study demonstrated that the GnRH antagonist protocol was associated with a similar clinical pregnancy rate without incidence of severe OHSS,and requiring lower gonadotrophin dosage compared with dual suppression protocol and GnRH agonist follicular initiation protocol.The GnRH antagonist protocol obtains much higher clinical pregnancy rate than IVM protocol,it might be the treatment choice for patients with PCOS undergoing IVF.