Comparative Evaluation of High Vs Low Ovarian Stimulation Doses in PCOS Patients: Impact on ICSI Outcomes

Background Currently, the optimal method of ovarian stimulation (OS) to in-vitro fertilization (IVF) in the patients with polycystic ovarian syndrome (PCOS) is unknown. The present research aims to study the efficiency of High-OS method in treatment of infertile patients with PCOS and to compare it to low-OS one. Methods The study was an open randomized, parallel treatment clinical trial comparing high stimulatory gonadotropin dose (group A) to low stimulatory one (group B) in PCOS infertile women undergoing ICSI cycle for infertility management. IVF outcomes of two groups were analyzed statically. Results The statistical analysis showed that group (A) of high stimulation dose had a lower duration of days of stimulation (P 0.025), higher numbers of retrieved oocyte, higher number of M2 oocytes, higher embryos formed and higher pregnancy rates than group (B) of low stimulation dose. High-OS protocol resulted in higher fertilization and clinical pregnancy rates of 69.2% and 66.7% in relation to 63.5% and 51.7% in low-OS one with no added risk of OHSS. Conclusions High-OS with r-FSH may be one of optimal methods of controlled OS in non-obese infertile women with PCOS in respect to total dose of prescribed gonadotropin, the optimal number of retrieved oocytes and embryos obtained, fertilization rate and clinical pregnancy rate without increased risk of OHSS.