Impact of Polycystic Ovary Syndrome Hyperandrogenic Phenotypes A and Non-Hyperandrogenic D on Pregnancy Outcomes After in vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI)

Khaldoun Khamaiseh,1 Roba Bdeir,2 Mohammad Mahmoud Abukbeer,3 Rami Khamaiseh,4 Ali Nassar,3 Dina Nasser Al-Sawadha Jnr,3 Rasha Rakan Al Mraikhat,3 Marah Jamal Khraisat,3 Rana Radi Alawneh,3 Omar Al-Mansour3 1Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan; 2Department of Basic Scientific Sciences, Al-Balqa Applied University, Al-Salt, 19117 Jordan; 3Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan; 4Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanCorrespondence: Khaldoun Khamaiseh, Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Balqa Applied University, P.O. Box 206, Al-Salt, 19117, Jordan, Email [email protected]: This study aims to evaluate the association between polycystic ovary syndrome (PCOS) phenotypes A and D with primary and secondary pregnancy outcomes among PCOS vs non-PCOS patients after in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).Methods: A retrospective cohort design using data of eligible women aged 20– 40 years who had their first IVF treatment. The data were obtained from medical records. The women were either diagnosed with PCOS according to Rotterdam Criteria, namely phenotypes A and D or non-PCOS. Pregnancy outcome including (1) the rate of biochemical pregnancy and (2) ongoing clinical pregnancy and (3) the rate of miscarriage were measured. Furthermore, secondary outcome data were collected on (1) the number of oocytes retrieved, (2) the number and percentage of mature oocytes, (3) fertilization rate, (4) the percentage of grade 1 embryos on day 3 and (5) the percentage of grade 1 embryos on day 5.Results: A sample of 149 women was analyzed. For secondary pregnancy outcomes, PCOS women in groups A and D have lower oocyte maturity rate and lower fertilization oocyte ratio, as well as fewer grade 1 oocytes on day 3 in comparison to the control. Primary pregnancy outcomes have significantly lower values among PCOS women in group A with respect to biochemical pregnancy and ongoing clinical pregnancy and higher miscarriage rates in comparison to group D and the control group. Finally, group D and control did not differ significantly in the primary pregnancy outcomes.Conclusion: Patients with phenotype D have better IVF outcomes in comparison to phenotype A. Phenotype A, affects the IVF outcomes negatively possibly due to hyperandrogenism.Keywords: polycystic ovary syndrome, IVF, ICSI, pregnancy outcomes, oocytes, hyperandrogenism