A recent study, touted to be the first to compare the outcomes of IVM protocol involving FSH and hCG priming with oocyte retrieval after 38 hours and conventional IVF procedure (GnRH agonist or antagonist cycle) in infertile women with PCOS, reports that the IVM protocol is an effective alternative that is akin to the IVF.
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Dopamine agonists have emerged as a new treatment strategy to prevent ovarian hyperstimulation syndrome (OHSS) and reduce its severity. A recent randomized controlled trial reports that the incidence of OHSS in high-risk patients undergoing assisted reproduction can be reduced with the use of cabergoline (a dopamine agonist) at a low dose.

Amani AM Shaltout and coworkers from the Department of Obstetrics & Gynaecology, Cairo University, Egypt, evaluated the potential of cabergoline at a dose of 0.25 mg to reduce the incidence of OHSS in 200 participants. Women in the study group were administered cabergoline for 8 days starting from the day of hCG administration, while the controls received no treatment.
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The pathogenesis of ovarian hyperstimulation syndrome (OHSS), although not completely elucidated, is associated with the increased vascular endothelial growth factor (VEGF)-mediated blood vessel permeability. A recent hypothesis on OHSS pathophysiology proposed the involvement of intra- and extracellular calcium ions in the onset and development of OHSS. This was independent of, but not contradictory to, the vascular permeability mechanism. Now a retrospective comparative study has reported that intravenous infusion of calcium results in a considerably lower incidence of OHSS in polycystic ovary syndrome (PCOS) patients at high risk for developing the complication. Continue Reading

Metformin is frequently used to help induce ovulatory menstrual cycles in polycystic ovary syndrome (PCOS) patients with oligomenorrhea. A recent multicenter, prospective, randomized, double-blind study reports that 12 weeks of metformin treatment prior to and during IVF/ICSI cycles, as opposed to placebo, substantially increases pregnancy and live birth rates in non-obese PCOS patients. Continue Reading

Follicular fluid vascular endothelial growth factor (FF-VEGF) has been proposed to play a critical role in embryo implantation, fertilization, and follicular maturation. A new study has reported the association of higher levels of FF-VEGF₁₆₅ with less favorable clinical outcomes in patients undergoing IVF, as well as with patient characteristics such as age of ≥40 years, body mass index ≥30, and polycystic ovarian syndrome. The findings of the prospective study have been published in the journal, Reproductive Sciences. Continue Reading

Polycystic ovary syndrome (PCOS), affecting around 5-10% of all reproductive-aged women, is one of the most common causes of anovulation. The identification of the role of insulin resistance in women with PCOS, who are also commonly resistant to clomiphene citrate (CC), resulted in the use of insulin sensitizers. The use of metformin, an insulin-sensitizing agent, in PCOS patients undergoing IVF or ovulation induction has been extensively researched, but with divergent results. Now, a new study reports that metformin significantly reduces the incidence of ovarian hyperstimulation syndrome (OHSS) and miscarriage, while positively affecting the oocyte and embryo quality in CC-resistant PCOS women undergoing IVF. The results of the randomized controlled study have been published in the Journal of Obstetrics and Gynecology. Continue Reading

Elevated levels of homocysteine (Hcy) in the ovarian follicular fluid has been implicated to adversely affect follicular development, oocyte maturity, and pregnancy outcomes. Now, a new study published in Human Reproduction has established a correlation between high follicular fluid Hcy concentrations and poor oocyte and embryo quality in polycystic ovary syndrome (PCOS) patients undergoing assisted reproductive techniques. With this association, the study suggests that the follicular fluid Hcy levels measured on the day of oocyte pick up (dOPU) can be used as a marker for assessing oocyte and embryo quality, and fertilization rates in PCOS patients. Continue Reading