Jane Nani
Fertility Centers of Illinois, USA
Title: Freeze-all policy: Fresh vs. frozen-thawed embryo transfer in PCOS patients
Biography
Biography: Jane Nani
Abstract
Women with PCOS who undergo IVF are inherently at high risk of ovarian hyperstimulation syndrome (OHSS). OHSS is most severe when PCOS patients undergo fresh embryo transfer and become pregnant. Prevention is a primary strategy for minimizing OHSS in the IVF setting. To this end, cycle cancellation is recommended in most IVF centers when high ovarian response exceeds set criteria. In our tertiary IVF center, PCOS patients with high egg yields are recommended for a “freeze all” (FA) cycle rather than cycle cancellation. Specifically, when 35 eggs or more are retrieved, the patient is an automatic FA. However with lower egg yields, decision for FA hinges on the presence of early signs/symptoms of OHSS. We reviewed the IVF stimulations and outcomes of PCOS women who cycled in our IVF center over the past 8 months. We report on 44 pts. who met PCOS criteria and who underwent IVF. The majority of patients underwent and antagonist IVF protocol with HCG trigger. The number of eggs retrieved ranged between 7 and 42 eggs, with an average of 19 eggs and 15 patients had greater than or equal to 20 eggs retrieved. Fourteen patients met the criteria for FA. The clinical pregnancy rate per transfer infresh IVF was 59%. When adding subsequent frozen-thawed cycles, the cumulative pregnancy rate per cycle was 64%. The rate of severe OHSS was negligible.