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This retrospective study evaluated the clinical decision between continuing ovarian stimulation or canceling the cycle in patients with slow ovarian response (SOR).
Monitoring follicular growth rate in PCOS patients with slow ovarian response helps guide IVF cycle continuation decisions, while hCG supplementation may improve ovarian responsiveness and increase the likelihood of clinical pregnancy.
This retrospective study evaluated the clinical decision between continuing ovarian stimulation or canceling the cycle in patients with slow ovarian response (SOR). It also examined how SOR influences embryo developmental potential, in vitro fertilization (IVF) outcomes, and clinical pregnancy rates in women with polycystic ovary syndrome (PCOS) undergoing assisted reproductive treatment.
This study was conducted involving 482 women diagnosed with PCOS undergoing fertility treatment. Volunteers were categorized based on follicular growth dynamics into:
Additionally, data from patients whose cycles were canceled owing to severe SOR (C-SOR group, n = 18) were included for comparison. Key clinical and reproductive outcomes, including ovarian stimulation parameters, embryo development, and pregnancy outcomes, were systematically analyzed across the groups.
The average follicular growth rate in the control group was considerably greater than SOR group and the cycle-cancellation group (Table 1).
Patients in both the SOR and C-SOR groups needed longer gonadotropin (Gn) stimulation and higher total Gn doses. Importantly, human chorionic gonadotropin (hCG) supplementation showed potential benefits in improving ovarian responsiveness in SOR patients. However, if the follicular growth rate remained below 1.0 mm/day, cycle cancellation was advocated. Although the number of retrieved oocytes was lower in the SOR group compared with controls, there were no prominent differences in fertilization rate, transferable embryo rate, or high-quality embryo rate between groups.
Likewise, clinical pregnancy rates after fresh or frozen embryo transfer were comparable. But, the SOR group illustrated lower cumulative clinical pregnancy rates (75.22% vs. 88.34%) and cumulative live birth rates (57.52% vs. 68.8%) as opposed to the control group. After adjusting for confounding factors, logistic regression assessment indicated that the link between SOR and cumulative live birth rate was not prominent (adjusted OR = 0.77).
Tracking follicular growth dynamics helped clinicians manage IVF cycles and optimize outcomes in PCOS patients with SOR.
Frontiers in Endocrinology
The management of slow ovarian response in PCOS patients and its impact on clinical pregnancy outcomes
Yan Zhang et al.
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