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Publications

Journal Article Ppublish

PubMed: 39495342 DOI: 10.1007/s10815-024-03299-z

ICSI and PGT-A in PCOS phenotype-D patients: a matched case-control study versus idiopathic infertile women.

J Assist Reprod Genet 41(12):3423-3432

Authors: Alberto Vaiarelli, Danilo Cimadomo, Cecilia Rucci, Federica Innocenti, Marilena Taggi, Erika Pittana, Giulia Fiorentino, Pasquale Petrone, Daria Maria Soscia, Gemma Fabozzi, Rossella Mazzilli, Laura Rienzi, Filippo Maria Ubaldi, Rossella Elena Nappi, Gianluca Gennarelli

Affiliations

  • IVIRMA Global Research Alliance, Genera, Clinica Valle Giulia, Via G. De Notaris 2B, Rome, Italy.
  • IVIRMA Global Research Alliance, Genera, Clinica Valle Giulia, Via G. De Notaris 2B, Rome, Italy.
  • Department of Surgical Sciences, Gynecologic Unit, University of Rome Tor Vergata, Rome, Italy.
  • Department of Biology and Biotechnology 'Lazzaro Spallanzani', Laboratory of Biology and Biotechnology of Reproduction, University of Pavia, Pavia, Italy.
  • Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.
  • IVIRMA Global Research Alliance, B-Woman, Rome, Italy.
  • Department of Clinical and Molecular Medicine, University "Sapienza" of Rome, Rome, Italy.
  • Dipartimento Di Scienze Biomolecolari, Università Di Urbino "Carlo Bo", Urbino, Italia.
  • Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
  • Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, I.R.C.C.S. Matteo Foundation, Pavia, Italy.
  • IVIRMA Global Research Alliance, Livet, Turin, Italy.
  • Gynecology and Obstetrics 2U, Department of Surgical Sciences, S. Anna Hospital, University of Turin, Turin, Italy.

Abstract

PURPOSE

To assess oocyte competence and embryo chromosomal constitution in phenotype-D PCOS women undergoing ICSI for PGT-A at the blastocyst stage.

METHODS

Retrospective study at a private IVF center. In the period 2013-2021, 58 naïve phenotype-D PCOS women (i.e., oligomenorrhea, ovarian PCO-morphology, and absence of hyperandrogenism) underwent ICSI with ejaculated sperm for PGT-A. These cases were matched to 58 controls selected from 2211 naïve women with idiopathic infertility planned for the same treatment in the same period. The matching variables were age (≈ 36 years), BMI (≈ 22), cumulus oocyte complexes (COCs) retrieved (≈ 21-23), and sperm quality (≈ 43-45% men with all sperm parameters > 5th percentile). The primary outcome was euploid blastocyst rate (EBR) per cohort of inseminated oocytes.

RESULTS

Maturation rates per COCs and euploidy per biopsied blastocysts were similar. PCOS patients with phenotype-D showed higher fertilization per inseminated oocytes and higher blastulation per zygotes. This resulted into a higher EBR per inseminated oocytes and more euploid blastocysts available for transfer, although these differences adjusted for confounders were not significant. The live birth rate per first euploid transfers was comparable, so were all other outcomes considered.

CONCLUSIONS

Oocyte competence was not compromised in phenotype-D PCOS women, while good prognosis idiopathic infertile women might have unknown oocyte issues. In case of repeated failures after intrauterine insemination, a timely referral to IVF might represent an efficient strategy, in line with the "one-and-done" approach fulfilling a family planning perspective. Indeed, 22% of the phenotype-D PCOS women had 2 singleton LBs and 76% had surplus oocytes/euploid blastocysts after achieving ≥ 1 live birth.

MeSH

Blastocyst, Parturition, Genetics, Reproductive Techniques, Case-Control Studies, Phenotype, Fertilization In Vitro, Oocytes, Embryo Transfer, Sperm Injections, Intracytoplasmic, Live Birth, Spermatozoa