مقايسه نتايج IVF با سه پروتكل تحريك تخمك گذاري در بيماران نابارور مبتلا به سندرم تخمدان پلي كيستيك

Comparison of the IVF Outcome between Three Methods of Induction Ovulation in PCOS Patients

Introduction: Polycystic ovarian syndrome (PCOS) is the most important cause of oligoovulation and anovulation in women of reproductive age and in infertile women. Several approaches have been proposed to induce ovulation in PCOS patients. Gonadotropins are the classical and effective therapeutic options. The objective of this study was comparing of fertility rate with only FSH protocol, HMG protocol, and combination of FSH and HMG for ovulation induction. Methods: 95 infertile women with PCOS diagnosis according to Rotterdam criteria, who were IVF candidate from Montaserieh infertility center in Mashhad were selected. 25 patients underwent induction ovulation by recombinant FSH, 35 patients by HMG, and 35 patients by a combination of FSH and HMG. Assessment was done in the ninth day of the menstrual cycle and the day of HCG injection by intravaginal sonography. The mean size and number of follicles in each ovary, and the endometrial thickness was measured and recorded. After retrieval of the oocytes, in vitro incubation with sperms, and embryo development, number of embryos was recorded and embryos were transferred. Two weeks after fertilization, the pHCG test was done and if the test was positive, transvaginal ultrasound was performed for FHR after 6 weeks and if the result was positive fertility would be confirmed. Data were analyzed by t- test, ANOVA, and chi-square test, using SPSS version 16. Statistically significant value was defined as p<0.05. Results: In the response to treatment, endometrial thickness, mean number and size of follicles were the same in three treatment methods in the ninth day of menstrual cycle, and at the day of HCG injection. Only the mean numbers of follicles in the three groups were significantly different (p=0.032) in the right ovary in the ninth day of menstrual cycle. Other variables in three groups showed no significant differences. Conclusion: In this study, the result of treatment of PCOS patients by induction ovulation methods such as FSH, HMG, or combination of them demonstrated no differences in fertility outcome. Although fertility rate of FSH group was more than other groups, this might be attributed to the increased level of endogenous LH in PCOS patients.