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Pilehvari, S., Radnia, N., Ahmadiani, S., Talebi-Ghane, E., Alimohammadi, N., & Mousaei Tokaldani, Z. (2023). The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study. International Journal of Reproductive BioMedicine (IJRM), 21(11), 921–928. https://doi.org/10.18502/ijrm.v21i11.14655
https://doi.org/10.18502/ijrm.v21i11.14655
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authors
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Shamim Pilehvari
Shamim Pilehvari
Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran.
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Nahid Radnia
Nahid Radnia
Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran.
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Somayeh Ahmadiani
Somayeh Ahmadiani
Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran.
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Elaheh Talebi-Ghane
Elaheh Talebi-Ghane
Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Neda Alimohammadi
Neda Alimohammadi
Clinical Research Development Unit of Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
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Zahra Mousaei Tokaldani
Zahra Mousaei Tokaldani
Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran.
Published Date
- Dec 14, 2023
The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study
Abstract
Background: Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments.
Objective: This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy’s success.
Materials and Methods: This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique.
Results: In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF.
Conclusion: OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome.
Key words: Ovarian hyperstimulation syndrome, Fertilization, Polycystic ovary syndrome.
References
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[2] Motlagh Asghari K, Nejadghaderi SA, Alizadeh M, Sanaie S, Sullman MJM, Kolahi AA, et al. Burden of polycystic ovary syndrome in the Middle East and North Africa region, 1990–2019. Sci Rep 2022; 12: 7039.
[3] Nautiyal H, Imam SS, Alshehri S, Ghoneim MM, Afzal M, Alzarea SI, et al. Polycystic ovarian syndrome: A complex disease with a genetics approach. Biomedicines 2022; 10: 540.
[4] Rashid R, Ahmad Mir S, Kareem O, Ali T, Ara R, Malik A, et al. Polycystic ovarian syndrome-current pharmacotherapy and clinical implications. Taiwan J Obstet Gynecol 2022; 61: 40–50.
[5] Parker J, O’Brien C, Hawrelak J, Gersh FL. Polycystic ovary syndrome: An evolutionary adaptation to lifestyle and the environment. Int J Environ Res Public Health 2022; 19: 1336.
[6] Pei Ch-Zh, Jin L, Baek KH. Pathogenetic analysis of polycystic ovary syndrome from the perspective of omics. Biomed Pharmacother 2021; 142: 112031.
[7] Yang H, Xiao Y-Q, Liu J-J, Xu G-X, Li J, Xiao Zh-Y, et al. Effect of non-pharmacological interventions for overweight/obese women with polycystic ovary syndrome on ovulation and pregnancy outcomes: A protocol for a systematic review and network meta-analysis. BMJ Open 2022; 12: e059090.
[8] Pundir J, Charles D, Sabatini L, Hiam D, Jitpiriyaroj S, Teede H, et al. Overview of systematic reviews of non-pharmacological interventions in women with polycystic ovary syndrome. Hum Reprod Update 2019; 25: 243–256.
[9] Li D, Guo Y, Lu S, Zhong Y, Zhu W, Liu Q. Analysis of 24 cases of polycystic ovary syndrome after failed controlled ovarian hyperstimulation. Clin Med 2019; 19: 350–352.
[10] Tanbo T, Mellembakken J, Bjercke S, Ring E, Åbyholm T, Fedorcsak P. Ovulation induction in polycystic ovary syndrome. Acta Obstet Gynecol Scand 2018; 97: 1162– 1167.
[11] Chen Y, Ye B, Yang X, Zheng J, Lin J, Zhao J. Predicting the outcome of different protocols of in vitro fertilization with anti-Muüllerian hormone levels in patients with polycystic ovary syndrome. J Int Med Res 2017; 45: 1138–1147.
[12] Seok HH, Song H, Lyu SW, Kim YS, Lee DR, Lee WS, et al. Application of serum anti-Müllerian hormone levels in selecting patients with polycystic ovary syndrome for in vitro maturation treatment. Clin Exp Reprod Med 2016; 43: 126–132.
[13] Melado Vidales L, Fernández-Nistal A, Martínez Fernández V, Verdú Merino V, Bruna Catalán I, Bajo Arenas JM. Anti-Müllerian hormone levels to predict oocyte maturity and embryo quality during controlled ovarian hyperstimulation. Minerva Ginecol 2017; 69: 225–232.
[14] Melado Vidales L, Fernández-Nistal A, Martínez Fernández V, Verdú Merino V, Bruna Catalán I, Bajo Arenas JM. Anti-Müllerian hormone dynamics during GNRH-antagonist short protocol for IVF/ICSI in women with varying ovarian reserve levels. Minerva Ginecol 2017; 69: 128–134.
[15] van Keizerswaard J, Dietz de Loos ALP, Louwers YV, Laven JSE. Changes in individual polycystic ovary syndrome phenotypical characteristics over time: A long-term follow-up study. Fertil Steril 2022; 117: 1059– 1066.
[16] Zaman A, Rothman MS. Postmenopausal hyperandrogenism: Evaluation and treatment strategies. Endocrinol Metab Clin North Am 2021; 50: 97–111.
[17] Namavar Jahromi B, Parsanezhad ME, Shomali Z, Bakhshai P, Alborzi M, Moin Vaziri N, et al. Ovarian hyperstimulation syndrome: A narrative review of its pathophysiology, risk factors, prevention, classification, and management. Iran J Med Sci 2018; 43: 248–260.
[18] Mai Zh, Liu M, Pan P, Li L, Huang J, Chen X, et al. Comparison of cumulative live birth rate between aged PCOS women and controls in IVF/ICSI cycles. Front Endocrinol 2021; 12: 724333.
[19] Baksh S, Casper A, Christianson MS, Devine K, Doody KJ, Ehrhardt S, et al. Natural vs. programmed cycles for frozen embryo transfer: Study protocol for an investigator-initiated, randomized, controlled, multicenter clinical trial. Trials 2021; 22: 660.
[20] Jiang X, Deng Ch-Y, Sun Zh-Y, Chen W-L, Wang H-B, Zhou Y-Zh, et al. Pregnancy outcomes of in vitro fertilization with or without ovarian hyperstimulation syndrome: A retrospective cohort study in chinese patients. Chin Med J 2015; 128: 3167–3172.
[21] Ganer Herman H, Mizrachi Y, Horowitz E, Weissman A, Sabban B, Gluck O, et al. Obstetric outcomes following ovarian hyperstimulation syndrome in IVFa comparison with uncomplicated fresh and frozen transfer cycles. BMC Pregnancy Childbirth 2022; 22: 573.
[22] Raziel A, Schachter M, Friedler Sh, Ron-El R. Outcome of IVF pregnancies following severe OHSS. Reprod Biomed Online 2009; 19: 61–65.
[23] Peigné M, Bernard V, Dijols L, Creux H, Robin G, Hocké C, et al. Using serum anti-Müllerian hormone levels to predict the chance of live birth after spontaneous or assisted conception: A systematic review and meta-analysis. Hum Reprod 2023; 53: 1789–1806.
[24] Cook CL, Siow Y, Taylor S, Fallat ME. Serum müllerian-inhibiting substance levels during normal menstrual cycles. Fertil Steril 2000; 73: 859–861.
[25] Lee T-H, Liu C-H, Huang C-C, Wu Y-L, Shih Y-T, Ho H-N, et al. Serum anti-Müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod 2008; 23: 160–167
[2] Motlagh Asghari K, Nejadghaderi SA, Alizadeh M, Sanaie S, Sullman MJM, Kolahi AA, et al. Burden of polycystic ovary syndrome in the Middle East and North Africa region, 1990–2019. Sci Rep 2022; 12: 7039.
[3] Nautiyal H, Imam SS, Alshehri S, Ghoneim MM, Afzal M, Alzarea SI, et al. Polycystic ovarian syndrome: A complex disease with a genetics approach. Biomedicines 2022; 10: 540.
[4] Rashid R, Ahmad Mir S, Kareem O, Ali T, Ara R, Malik A, et al. Polycystic ovarian syndrome-current pharmacotherapy and clinical implications. Taiwan J Obstet Gynecol 2022; 61: 40–50.
[5] Parker J, O’Brien C, Hawrelak J, Gersh FL. Polycystic ovary syndrome: An evolutionary adaptation to lifestyle and the environment. Int J Environ Res Public Health 2022; 19: 1336.
[6] Pei Ch-Zh, Jin L, Baek KH. Pathogenetic analysis of polycystic ovary syndrome from the perspective of omics. Biomed Pharmacother 2021; 142: 112031.
[7] Yang H, Xiao Y-Q, Liu J-J, Xu G-X, Li J, Xiao Zh-Y, et al. Effect of non-pharmacological interventions for overweight/obese women with polycystic ovary syndrome on ovulation and pregnancy outcomes: A protocol for a systematic review and network meta-analysis. BMJ Open 2022; 12: e059090.
[8] Pundir J, Charles D, Sabatini L, Hiam D, Jitpiriyaroj S, Teede H, et al. Overview of systematic reviews of non-pharmacological interventions in women with polycystic ovary syndrome. Hum Reprod Update 2019; 25: 243–256.
[9] Li D, Guo Y, Lu S, Zhong Y, Zhu W, Liu Q. Analysis of 24 cases of polycystic ovary syndrome after failed controlled ovarian hyperstimulation. Clin Med 2019; 19: 350–352.
[10] Tanbo T, Mellembakken J, Bjercke S, Ring E, Åbyholm T, Fedorcsak P. Ovulation induction in polycystic ovary syndrome. Acta Obstet Gynecol Scand 2018; 97: 1162– 1167.
[11] Chen Y, Ye B, Yang X, Zheng J, Lin J, Zhao J. Predicting the outcome of different protocols of in vitro fertilization with anti-Muüllerian hormone levels in patients with polycystic ovary syndrome. J Int Med Res 2017; 45: 1138–1147.
[12] Seok HH, Song H, Lyu SW, Kim YS, Lee DR, Lee WS, et al. Application of serum anti-Müllerian hormone levels in selecting patients with polycystic ovary syndrome for in vitro maturation treatment. Clin Exp Reprod Med 2016; 43: 126–132.
[13] Melado Vidales L, Fernández-Nistal A, Martínez Fernández V, Verdú Merino V, Bruna Catalán I, Bajo Arenas JM. Anti-Müllerian hormone levels to predict oocyte maturity and embryo quality during controlled ovarian hyperstimulation. Minerva Ginecol 2017; 69: 225–232.
[14] Melado Vidales L, Fernández-Nistal A, Martínez Fernández V, Verdú Merino V, Bruna Catalán I, Bajo Arenas JM. Anti-Müllerian hormone dynamics during GNRH-antagonist short protocol for IVF/ICSI in women with varying ovarian reserve levels. Minerva Ginecol 2017; 69: 128–134.
[15] van Keizerswaard J, Dietz de Loos ALP, Louwers YV, Laven JSE. Changes in individual polycystic ovary syndrome phenotypical characteristics over time: A long-term follow-up study. Fertil Steril 2022; 117: 1059– 1066.
[16] Zaman A, Rothman MS. Postmenopausal hyperandrogenism: Evaluation and treatment strategies. Endocrinol Metab Clin North Am 2021; 50: 97–111.
[17] Namavar Jahromi B, Parsanezhad ME, Shomali Z, Bakhshai P, Alborzi M, Moin Vaziri N, et al. Ovarian hyperstimulation syndrome: A narrative review of its pathophysiology, risk factors, prevention, classification, and management. Iran J Med Sci 2018; 43: 248–260.
[18] Mai Zh, Liu M, Pan P, Li L, Huang J, Chen X, et al. Comparison of cumulative live birth rate between aged PCOS women and controls in IVF/ICSI cycles. Front Endocrinol 2021; 12: 724333.
[19] Baksh S, Casper A, Christianson MS, Devine K, Doody KJ, Ehrhardt S, et al. Natural vs. programmed cycles for frozen embryo transfer: Study protocol for an investigator-initiated, randomized, controlled, multicenter clinical trial. Trials 2021; 22: 660.
[20] Jiang X, Deng Ch-Y, Sun Zh-Y, Chen W-L, Wang H-B, Zhou Y-Zh, et al. Pregnancy outcomes of in vitro fertilization with or without ovarian hyperstimulation syndrome: A retrospective cohort study in chinese patients. Chin Med J 2015; 128: 3167–3172.
[21] Ganer Herman H, Mizrachi Y, Horowitz E, Weissman A, Sabban B, Gluck O, et al. Obstetric outcomes following ovarian hyperstimulation syndrome in IVFa comparison with uncomplicated fresh and frozen transfer cycles. BMC Pregnancy Childbirth 2022; 22: 573.
[22] Raziel A, Schachter M, Friedler Sh, Ron-El R. Outcome of IVF pregnancies following severe OHSS. Reprod Biomed Online 2009; 19: 61–65.
[23] Peigné M, Bernard V, Dijols L, Creux H, Robin G, Hocké C, et al. Using serum anti-Müllerian hormone levels to predict the chance of live birth after spontaneous or assisted conception: A systematic review and meta-analysis. Hum Reprod 2023; 53: 1789–1806.
[24] Cook CL, Siow Y, Taylor S, Fallat ME. Serum müllerian-inhibiting substance levels during normal menstrual cycles. Fertil Steril 2000; 73: 859–861.
[25] Lee T-H, Liu C-H, Huang C-C, Wu Y-L, Shih Y-T, Ho H-N, et al. Serum anti-Müllerian hormone and estradiol levels as predictors of ovarian hyperstimulation syndrome in assisted reproduction technology cycles. Hum Reprod 2008; 23: 160–167