What question did this study set out to answer?

To compare IVF outcomes between patients with and without polycystic ovary syndrome (PCOS) and assess risks associated with high ovarian response.

January 21, 2026Open Access

Comparison of in vitro fertilization outcomes between patients with and without polycystic ovary syndrome

Key Points

To compare IVF outcomes between patients with and without polycystic ovary syndrome (PCOS) and assess risks associated with high ovarian response.
Data from 3841 IVF cycles with high ovarian response were analyzed.
Participants were divided into PCOS and non-PCOS groups after propensity score matching, with 649 cycles in each group.
Hormonal levels, oocyte retrieval, embryo quality, and clinical pregnancy rates were evaluated for both groups.
PCOS group had higher anti-Müllerian hormone levels compared to non-PCOS group (8.30 vs 6.36; P < .001).
Higher antral follicle count in PCOS group (22.71 vs 19.56; P < .001).
Significantly more oocytes retrieved in PCOS group (23.33 vs 22.57; P = .025).
Higher clinical pregnancy rates in PCOS group (84.2% vs 74.0%; P = .012).
Live birth rates were also higher in PCOS group (73.8% vs 61.2%; P = .001).

Abstract

This study aims to investigate the increased risk of adverse pregnancy outcomes on patients who have a polycystic ovary syndrome (PCOS) with high ovarian response. The data of patients (3841 cycles) with ovarian high response who conceive in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in our hospital from January 2016 to June 2020 were picked out. According to with or without PCOS, the cycles were divided into PCOS group and non-PCOS group. After propensity score matching matching, 649 cycles in each group were analyzed. There was no significant difference in general conditions between the 2 groups ( P > .05), but the Anti-Müllerian hormone (8.30 ± 3.96 vs 6.36 ± 3.42; P < .001***) and Antral follicle count (AFC) (22.71 ± 4.56 vs 19.56 ± 5.66; P < .001***) of PCOS group were significantly higher than those of non-PCOS group. No significant differences were found in the thickness of endometrium on the day of human chorionic gonadotropin (hCG) day (12.28 ± 2.38 vs 12.18 ± 2.41; P = .444) but progesterone (0.97 ± 0.57 vs 1.16 ± 0.69; P < .001***) was remarkably lower than that in non-PCOS group. Number of oocytes retrieved (23.33 ± 6.45 vs 22.57 ± 5.73; P = .025*), high-quality embryo rate (60.6 vs 53.6; P < .001***) and high-quality blastocyst rate (15.2 vs 11.5; P < .001***) were significantly higher in the PCOS group than those in the non-PCOS group. The rates of freezing all embryos cycles due to high ovarian response (52.4 vs 43.1; P = .001**), clinical pregnancy (84.2 vs 74.0; P = .012*) and live birth (73.8 vs 61.2; P = .001**) were all significantly higher in PCOS group than non-PCOS group, however, with no significant difference in the rates of preterm birth (6.3 vs 9.9; P = .153), ovarian hyperstimulation syndrome (OHSS) (3.5 vs 3.7; P = .179) and OHSS in clinical pregnancy (3.2 vs 3.8; P = .067) between the 2 groups were found. These findings suggest that tailored treatment protocols, including individualized ovarian stimulation strategies and careful management of OHSS, may optimize reproductive outcomes in high-response PCOS patients.

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