Angeline Beltsos
Fertility Centers of Illinois, USA
Title: New IVF paradigm for management of PCOS: PGS followed by e-SET
Biography
Biography: Angeline Beltsos
Abstract
Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. This syndrome is manifested by endocrine and metabolic dysfunctions which result in a markedly altered ovarian milieu. This environment is characterized by mutations in both the cumulus cell complexes of the oocyte as well as significant transcriptomic and secretomic alterations in the blastocyst. These factors result in a higher number of immature oocytes, possibly poorer quality oocytes, decreased rates of fertilization, decreased blastulation and blastocyst quality, less implantation and higher rates of miscarriage. Practical management of these patients remains difficult. Moving to IVF with careful stimulation, agonist trigger followed by freeze all, PGS and then single frozen embryo transfer may provide optimal results. Mitigating risks of PCOS patients doing IVF specifically their increased potential for excessive ovarian response (OHSS) coupled by a higher IVF cancellation rate is important. Increased evidence demonstrates that higher IVF implantation rates and improved pregnancy outcomes can be achieved by pre-implantation genetic screening, followed by frozen embryo transfer which may improve placentation and infant health as well. With additional data to support this trend, a new IVF paradigm is evolving single, genetically healthy FET. Applying this technology to the PCOS patient may provide an ideal outcome for many patients.