Background & Objective: Polycystic Ovary Syndrome (PCOS) is associated with distinct metabolic and androgenic profiles that can impact fertility outcomes. While ovarian stimulation is a cornerstone of assisted reproductive technology, its real-time metabolic and hormonal effects are not fully captured by conventional static measurements. This study was conducted with aim to compare the dynamic changes in serum Homocysteine (HCY) and testosterone from baseline (cycle day 2) to the day of Ovum Pick-Up (OPU) in women with and without PCOS undergoing ovarian stimulation. Materials & Methods: This prospective cohort study was conducted on 40 women undergoing Intracytoplasmic Sperm Injection (ICSI) who were categorized into PCOS (n=19) and non-PCOS (n=21) groups. Serum HCY and testosterone were measured at both CD2 and OPU, while baseline estradiol (E2) was measured on CD2. Oocyte maturation was assessed and categorized. Results: The PCOS group compared to the non-PCOS group had a significantly higher number of retrieved oocytes (20 vs. 6, P<0.05) and mature MII oocytes (15 vs. 4, P<0.05). Baseline HCY and testosterone levels were lower in PCOS women (P<0.05). Younger PCOS patients with a normal BMI showed a 92.4% increase in testosterone from CD2 to OPU (P<0.015), while older non-PCOS women with a normal BMI had a 76.0% increase in HCY (P<0.001). In PCOS patients, HCY levels were highly stable from CD2 to OPU (r=0.849), whereas in non-PCOS patients, E2 levels were negatively correlated with GV oocytes (r=-0.597, P<0.01). Conclusion: The findings suggest that women with PCOS display a different pattern of metabolic and hormonal adaptation during ovarian stimulation compared to non-PCOS women. These group-specific dynamic biomarker patterns are associated with oocyte maturation outcomes. Incorporating dynamic assessments of HCY and testosterone may offer a more nuanced understanding of ovarian response and oocyte quality, potentially informing personalized stimulation protocols.
Bayati et al. (Fri,) studied this question.