Patients with PCOS are a wide group of patients and [Inaudible 0:00:20] a very high number of follicles leaving the ovaries. And on the one hand, it seems to be good due to the possibility to retrieve many oocytes, but on the other hand, there is a risk of serious complications during the procedure like ovarian hyper-stimulation syndrome. Fortunately, right now we have treatment options for such patients, which permit us to achieve a balance between the risk of complications and good response for the simulation. So for this purpose – for high responders and for patients with PCOS, it is recommended to use what is called the GnRH agonist and change the trigger for final oocyte maturation from HCG to GnRH and then we prefer to freeze down all good quality embryos and perform a frozen embryo transfer one cycle later. And regarding all international guidelines with this type of protocol; segmentation of the cycle is recommended for high responders and patients with PCOS.
It is considered that most women with PCOS have good prognosis and achieve treatment with simple treatment such as Intrauterine Insemination. Those who finally need IVF are usually because they do not respond to ovarian stimulation or have adequate oocyte quality.
Between patients with low ovarian reserve and patients with PCO syndrome, let’s say that we prefer PCO patients because we know that we can take many oocytes. Many oocytes usually, not every time, usually have a high success rate, meaning high number of blastocyst and high success rate.
Basic thing in any case we have to prepare very well for the PCO patient giving her treatment which means metformin, aerobic activity and good alimentation. In any case all this basic advice that she should take and then to prepare her with good protocol for an IVF cycle.
It is successful in IVF patients. I repeat we usually prefer these patients because they produce many oocytes and usually they become pregnant if not in the first try then in the second try after thawing the embryos we have pregnancies.
