FEATURES OF CONTROLLED OVULATORY STIMULATION AND EMBRYONIC DEVELOPMENT IN INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME Article Swipe

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YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.24061/1727-4338.xxiv.3.93.2025.06

Infertility, associated with polycystic ovary syndrome (PCOS), especially whencombined with metabolic syndrome, is a complex clinical problem in modernreproductive medicine. Metabolic disorders cause resistance to gonadotropins, reduceoocyte quality, and impaire embryonic development, even with the use of assistedreproductive technologies.The aim – to analyze the characteristics of controlled ovulatory stimulation, fertilizationrates, and embryonic development in patients with polycystic ovary syndrome combinedwith metabolic syndrome.Materials and methods. A retrospective analysis of 120 cycles of in vitro fertilization inwomen with infertility who were treated at the medical center “Clinic of Professor StefanKhmil” during 2013–2023 was conducted. The study was conducted in accordance withthe provisions of the Helsinki Declaration (2013), the Council of Europe Convention onHuman Rights and Biomedicine (1997), and Order No. 690 of the Ministry of Health ofUkraine dated 2009 (as amended by № 523 dated 2012). The study was approved by theBioethics Committee of the I. Ya. Gorbachevsky Ternopil National Medical University(Minutes No. 75 of November 1, 2023). Patients were divided into three comparablegroups: the main group (n=46) – PCOS + MS, the comparison group (n=44) – PCOSwithout MS, the control group (n=30) – tubal factor infertility. The diagnosis of PCOSwas established according to the Rotterdam criteria (ESHRE/ASRM, 2003), and MS –according to the International Diabetes Federation (IDF, 2005). The study includedwomen aged 24–36 years with primary or secondary female infertility, indications forIVF with their own oocytes, and complete medical documentation for all stages ofstimulation, puncture, fertilization, and embryo culture. Exclusion criteria were ageover 37 years, the presence of other factors of infertility, contraindications for the useof ART treatment programs, as defined by the Procedure for the use of assistedreproductive technologies in Ukraine (Order of the Ministry of Health of Ukraine09.09.2013 No. 787); use of donor gametes or surrogacy. The IVF protocol includedcontrolled superovulation stimulation, transvaginal follicular puncture, ICSIfertilization, embryo cultivation to the blastocyst stage, and cryopreservation. Theduration of stimulation, total dose of gonadotropins, number and quality of oocytes,proportion of normally fertilized (2PN) oocytes, blastulation rate, and number ofblastocysts obtained were evaluated. The results were processed using Microsoft Exceland Statistica. The Shapiro-Wilk test was used to check the normality of the distribution,intergroup differences were assessed using the Kruskal-Wallis test, and the dynamics ofindicators within groups were assessed using the Wilcoxon test. The level of statisticalsignificance was set at p<0.05.Results. Women with PCOS and MS had longer stimulation duration (11.5 ± 2.1 days)and higher total gonadotropin dose (2875 ± 780 IU) with lower ovarian sensitivity index(7.68 ± 2.1). The number of oocytes obtained (22.1 ± 6.2) did not correlate with thesubsequent fertilization rate. The frequency of normal fertilization (2PN) was reduced(76.1%), as was the blastulation rate (39.0%), compared to other groups. This isprobably due to metabolic disorders in the microenvironment of the follicles, increasedinsulin resistance, and oxidative stress, which negatively affect the quality of oocytesand subsequent embryonic development.Conclusions. The combination of PCOS and metabolic syndrome is accompanied by adecrease in gamete quality and embryonic development at maintaining ovarian reserve.This confirms the need for personalized stimulation protocols and metabolic correctionduring the pre-pregnancy preparation stage.

Related Topics

Polycystic Ovary Syndrome

In Vitro Fertilisation

Ovulation

Internal Medicine

Obstetrics And Gynaecology

Pregnancy

Obstetrics

Endocrinology

Concepts

Polycystic ovary Medicine Infertility Gynecology Christian ministry Metabolic syndrome Insulin resistance Ovulation induction In vitro fertilisation Declaration of Helsinki Reproductive medicine Ovulation Internal medicine Diabetes mellitus Female infertility Obstetrics and gynaecology Pregnancy Obstetrics Endocrinology Helsinki declaration

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Landing Page: https://doi.org/10.24061/1727-4338.xxiv.3.93.2025.06
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Title: FEATURES OF CONTROLLED OVULATORY STIMULATION AND EMBRYONIC DEVELOPMENT IN INFERTILE WOMEN WITH POLYCYSTIC OVARY SYNDROME AND METABOLIC SYNDROME

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Authors: S. V. Khmil, Y.B. Pravak

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Concepts: Polycystic ovary, Medicine, Infertility, Gynecology, Christian ministry, Metabolic syndrome, Insulin resistance, Ovulation induction, In vitro fertilisation, Declaration of Helsinki, Reproductive medicine, Ovulation, Internal medicine, Diabetes mellitus, Female infertility, Obstetrics and gynaecology, Pregnancy, Obstetrics, Endocrinology, Helsinki declaration

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abstract_inverted_index.duration	385
abstract_inverted_index.dynamics	359
abstract_inverted_index.methods.	63
abstract_inverted_index.normally	318
abstract_inverted_index.obtained	327, 409
abstract_inverted_index.oocytes,	224, 321
abstract_inverted_index.patients	54
abstract_inverted_index.presence	245
abstract_inverted_index.protocol	289
abstract_inverted_index.quality,	27
abstract_inverted_index.syndrome	5, 58, 471
abstract_inverted_index.Committee	140
abstract_inverted_index.Exclusion	238
abstract_inverted_index.Metabolic	20
abstract_inverted_index.Microsoft	335
abstract_inverted_index.Procedure	262
abstract_inverted_index.Professor	86
abstract_inverted_index.Rotterdam	193
abstract_inverted_index.according	190
abstract_inverted_index.adecrease	475
abstract_inverted_index.conducted	95
abstract_inverted_index.correlate	415
abstract_inverted_index.diagnosis	186
abstract_inverted_index.disorders	21, 443
abstract_inverted_index.embryonic	30, 51, 463, 480
abstract_inverted_index.frequency	421
abstract_inverted_index.medicine.	19
abstract_inverted_index.metabolic	10, 60, 442, 470, 494
abstract_inverted_index.normality	346
abstract_inverted_index.ofUkraine	124
abstract_inverted_index.ovulatory	47
abstract_inverted_index.oxidative	453
abstract_inverted_index.processed	333
abstract_inverted_index.programs,	257
abstract_inverted_index.protocols	492
abstract_inverted_index.puncture,	233, 295
abstract_inverted_index.secondary	216
abstract_inverted_index.syndrome,	11
abstract_inverted_index.treatment	256
abstract_inverted_index.“Clinic	84
abstract_inverted_index.Convention	109
abstract_inverted_index.Federation	204
abstract_inverted_index.accordance	97
abstract_inverted_index.associated	1
abstract_inverted_index.blastocyst	301
abstract_inverted_index.comparison	171
abstract_inverted_index.conducted.	91
abstract_inverted_index.controlled	46
abstract_inverted_index.especially	7
abstract_inverted_index.evaluated.	329
abstract_inverted_index.fertilized	319
abstract_inverted_index.follicles,	449
abstract_inverted_index.follicular	294
abstract_inverted_index.index(7.68	402
abstract_inverted_index.isprobably	439
abstract_inverted_index.negatively	456
abstract_inverted_index.oocytesand	461
abstract_inverted_index.polycystic	3, 56
abstract_inverted_index.provisions	99
abstract_inverted_index.resistance	23
abstract_inverted_index.subsequent	462
abstract_inverted_index.surrogacy.	286
abstract_inverted_index.2013–2023	89
abstract_inverted_index.Biomedicine	113
abstract_inverted_index.Declaration	103
abstract_inverted_index.PCOSwithout	175
abstract_inverted_index.Statistica.	337
abstract_inverted_index.Theduration	305
abstract_inverted_index.accompanied	473
abstract_inverted_index.combination	466
abstract_inverted_index.cultivation	298
abstract_inverted_index.development	52, 481
abstract_inverted_index.differences	350
abstract_inverted_index.established	189
abstract_inverted_index.indications	219
abstract_inverted_index.infertility	76
abstract_inverted_index.maintaining	483
abstract_inverted_index.preparation	498
abstract_inverted_index.resistance,	451
abstract_inverted_index.sensitivity	401
abstract_inverted_index.stimulation	384, 491
abstract_inverted_index.(ESHRE/ASRM,	195
abstract_inverted_index.Gorbachevsky	145
abstract_inverted_index.Infertility,	0
abstract_inverted_index.Shapiro-Wilk	339
abstract_inverted_index.blastulation	322, 431
abstract_inverted_index.combinedwith	59
abstract_inverted_index.development,	31
abstract_inverted_index.gonadotropin	392
abstract_inverted_index.infertility,	218, 250
abstract_inverted_index.infertility.	184
abstract_inverted_index.ofindicators	360
abstract_inverted_index.personalized	490
abstract_inverted_index.reduceoocyte	26
abstract_inverted_index.reserve.This	485
abstract_inverted_index.stimulation,	48, 292, 307
abstract_inverted_index.technologies	268
abstract_inverted_index.theBioethics	139
abstract_inverted_index.transvaginal	293
abstract_inverted_index.whencombined	8
abstract_inverted_index.–according	199
abstract_inverted_index.International	202
abstract_inverted_index.documentation	228
abstract_inverted_index.fertilization	73, 418, 424
abstract_inverted_index.includedwomen	209
abstract_inverted_index.ofblastocysts	326
abstract_inverted_index.pre-pregnancy	497
abstract_inverted_index.retrospective	65
abstract_inverted_index.thesubsequent	417
abstract_inverted_index.Kruskal-Wallis	355
abstract_inverted_index.StefanKhmil”	87
abstract_inverted_index.fertilization,	234
abstract_inverted_index.gonadotropins,	25, 311
abstract_inverted_index.ofstimulation,	232
abstract_inverted_index.superovulation	291
abstract_inverted_index.characteristics	44
abstract_inverted_index.reduced(76.1%),	427
abstract_inverted_index.correctionduring	495
abstract_inverted_index.increasedinsulin	450
abstract_inverted_index.microenvironment	446
abstract_inverted_index.technologies.The	38
abstract_inverted_index.Ukraine09.09.2013	278
abstract_inverted_index.comparablegroups:	161
abstract_inverted_index.contraindications	251
abstract_inverted_index.cryopreservation.	304
abstract_inverted_index.ICSIfertilization,	296
abstract_inverted_index.University(Minutes	149
abstract_inverted_index.includedcontrolled	290
abstract_inverted_index.modernreproductive	18
abstract_inverted_index.oocytes,proportion	316
abstract_inverted_index.p<0.05.Results.	376
abstract_inverted_index.syndrome.Materials	61
abstract_inverted_index.fertilizationrates,	49
abstract_inverted_index.assistedreproductive	37, 267
abstract_inverted_index.distribution,intergroup	349
abstract_inverted_index.statisticalsignificance	372
abstract_inverted_index.development.Conclusions.	464
cited_by_percentile_year
countries_distinct_count	0
institutions_distinct_count	2
citation_normalized_percentile