Maintained number of oocytes with advanced age in PCOS women during IVF treatment compared to controls

Abstract

PCOS is the most common reason to anovulatory infertility, and previous observations suggest that the fertility in these women increases when ageing. We wanted to investigate whether PCOS women have an increased age related ovarian response to ovulation induction, compared to patients with normal ovaries, with respect to the number of collected oocytes, clinical pregnancies and live births. 1500 patients ranging from 20-44 years of age were evaluated in this study. By selection of patients from our clinical database at Kvinneklinikken, Rikshospitalet, we ended up with a case cohort of 500 infertile women with PCOS treated with IVF. Two control cohorts were selected from infertile women with tubal factor infertility only and male factor infertility only. A similar distribution of age among the groups was obtained by matching, ending with 500 patients in each group. In the PCOS group, no significant association between age and number of collected oocytes was observed. In the tubal and male factor infertility groups, advanced age was associated with reduced number of retrieved oocytes. In the PCOS and the male factor infertility groups, a significant association between age and live birth rate were not observed. In the tubal factor infertility group, advanced age was associated with a significantly reduced probability for live birth. The results demonstrate that the ovarian capacity to release oocytes remain stable with advancing age in PCOS women, whereas it decreases in control women. It may also indicate that PCOS women do not have a decline in fertility until at least 40 years of age, whereas it decreases in normal controls.