Iranian Society of Gynecology Oncology


1 Reproductive Health Research Center, Tehran University of Medical Sciences, Tehran Iran

2 Psychiatry Department, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran


Background: Both in-vitro maturation and in-vitro fertilization have been used successfully to treat females with polycystic ovarian syndrome, who plan to have child. This study compared outcome of these two approaches to fertilize females with polycystic ovary side effects.
Methods: This prospective study was conducted at Vali-Asr reproductive health research center and included all females with polycystic ovarian syndrome, who underwent in-vitro maturation or in-vitro fertilization from January 2005 to January 2008. Measurements included demographic data, total cost (including drug and laboratory procedures), outcome (chemical and clinical pregnancy), and systemic complication (ovarian hyper-stimulation syndrome), obtained from the patients’ clinical files. Patients were informed about the procedures, side effects and goals, and the signed consent form for surgical approaches and use of their data in medical research. Finally, these variables were compared between the two groups.
Results: The in-vitro maturation and in-vitro fertilization groups included 20 and 22 patients, respectively. The range of body mass index was between 17.4 and 28.3 kg/m2 and the mean age of the patients was 29.35 ± 4.94 and 28.95 ± 3.84 years, respectively (P > 0.05). The total cost was significantly lower in in-vitro maturation group compared to in-vitro fertilization (201.6 ± 60.1 USD versus 380.5 ± 143.8 USD, respectively, P < 0.001). Positive outcomes were achieved significantly more frequently with the in-vitro fertilization method (1 chemical and no clinical pregnancy in in-vitro maturation versus 7 and 6 in in-vitro fertilization group, respectively, P < 0.001). Although, the rate of ovarian hyper-stimulation syndrome was higher in in-vitro fertilization than in in-vitro maturation approach, yet, it was not statistically significant (P = 0.233).
Conclusions: Our findings showed the superiority of execution of the in-vitro fertilization approach compared with the in-vitro maturation method in infertile females with polycystic ovary syndrome, who planned to have a child. However, in-vitro maturation approach is cheaper than in-vitro fertilization and is also associated with lower risk of ovarian hyper-stimulation syndrome. 


  1. Thessaloniki EAPCWG. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril. 2008;89(3):505-22. [DOI:10.1016/j.fertnstert.2007.09.041] [PMID]
  2. Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370(9588):685-97. [DOI:10.1016/S0140-6736(07)61345-2]
  3. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352(12):1223-36. [DOI:10.1056/NEJMra041536] [PMID]
  4. Zhao JZ, Zhou W, Zhang W, Ge HS, Huang XF, Lin JJ. In vitro maturation and fertilization of oocytes from unstimulated ovaries in infertile women with polycystic ovary syndrome. Fertil Steril. 2009;91(6):2568-71. [DOI:10.1016/j.fertnstert.2008.03.059] [PMID]
  5. Homburg R. Polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2008;22(2):261-74. [DOI:10.1016/j.bpobgyn.2007.07.009] [PMID]
  6. Filali M, Hesters L, Fanchin R, Tachdjian G, Frydman R, Frydman N. Retrospective comparison of two media for invitro maturation of oocytes. Reprod Biomed Online. 2008;16(2):250-6. [DOI:10.1016/S1472-6483(10)60582-2]
  7. Le Du A, Kadoch IJ, Bourcigaux N, Doumerc S, Bourrier MC, Chevalier N, et al. In vitro oocyte maturation for the treatment of infertility associated with polycystic ovarian syndrome: the French experience. Hum Reprod. 2005;20(2):420-4. [DOI:10.1093/humrep/deh603] [PMID]
  8. Suikkari AM, Soderstrom-Anttila V. In-vitro maturation of eggs: is it really useful?. Best Pract Res Clin Obstet Gynaecol. 2007;21(1):145-55. [DOI:10.1016/j.bpobgyn.2006.09.003] [PMID]
  9. Cha KY, Koo JJ, Ko JJ, Choi DH, Han SY, Yoon TK. Pregnancy after in vitro fertilization of human follicular oocytes collected from nonstimulated cycles, their culture in vitro and their transfer in a donor oocyte program. Fertil Steril. 1991;55(1):109-13. [DOI:10.1016/S0015-0282(16)54068-0]
  10. Trounson A, Wood C, Kausche A. In vitro maturation and the fertilization and developmental competence of oocytes recovered from untreated polycystic ovarian patients. Fertil Steril. 1994;62(2):353-62. [DOI:10.1016/S0015-0282(16)56891-5]
  11. Child TJ, Phillips SJ, Abdul-Jalil AK, Gulekli B, Tan SL. A comparison of in vitro maturation and in vitro fertilization for women with polycystic ovaries. Obstet Gynecol. 2002;100(4):665-70. [DOI:10.1097/00006250-200210000-00009]
  12. Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210-7. [DOI:10.1111/j.1471-0528.2006.01008.x] [PMID]
  13. Cha KY, Lee DR, Cho JH, Yoon TK. In vitro maturation of immature oocytes and IVF/ICSI in PCOS patients. J Indian Med Assoc. 2006;104(8):446-448, 473.
  14. Lin YH, Hwang JL, Huang LW, Mu SC, Seow KM, Chung J, et al. Combination of FSH priming and hCG priming for in-vitro maturationof human oocytes. Hum Reprod. 2003;18(8):1632-6. [DOI:10.1093/humrep/deg335] [PMID]
  15. Child TJ, Abdul-Jalil AK, Gulekli B, Tan SL. In vitro maturation and fertilization of oocytes from unstimulated normal ovaries, polycystic ovaries, and women with polycystic ovary syndrome. Fertil Steril. 2001;76(5):936-42. [DOI:10.1016/S0015-0282(01)02853-9]
  16. Martikainen H, Tiitinen A, Tomas C, Tapanainen J, Orava M, Tuomivaara L, et al. One versus two embryo transfer after IVF and ICSI: a randomized study. Hum Reprod. 2001;16(9):1900-3. [DOI:10.1093/humrep/16.9.1900] [PMID]
  17. Cha KY, Chung HM, Lee DR, Kwon H, Chung MK, Park LS, et al. Obstetric outcome of patients with polycystic ovary syndrome treated by in vitro maturation and in vitro fertilization-embryo transfer. Fertil Steril. 2005;83(5):1461-5. [DOI:10.1016/j.fertnstert.2004.11.044] [PMID]
  18. Soderstrom-Anttila V, Makinen S, Tuuri T, Suikkari AM. Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients. Hum Reprod. 2005;20(6):1534-40. [DOI:10.1093/humrep/deh768] [PMID]
  19. Trounson A, Anderiesz C, Jones G. Maturation of human oocytes in vitro and their developmental competence. Reproduction. 2001;121(1):51-75. [DOI:10.1530/rep.0.1210051] [PMID]
  20. Senturk LM, Erel CT. Thin endometrium in assisted reproductive technology. Curr Opin Obstet Gynecol. 2008;20(3):221-8. [DOI:10.1097/GCO.0b013e328302143c] [PMID]
  21. Lin YH, Hwang JL. In vitro maturation of human oocytes. Taiwan J Obstet Gynecol. 2006;45(2):95-9. [DOI:10.1016/S1028-4559(09)60204-7]
  22. Trounson A, Anderiesz C, Jones GM, Kausche A, Lolatgis N, Wood C. Oocyte maturation. Hum Reprod. 1998;13 Suppl 3:52-62. [DOI:10.1093/humrep/13.suppl_3.52] [PMID]