For many women diagnosed with polycystic ovary syndrome (PCOS), the path of in vitro fertilization (IVF) often comes with a unique dilemma: "I have so many basal follicles, why are the quality of the eggs retrieved poor, but there are very few good embryos that can be used in the end?" Moreover, there is always a concern about the risk of ovarian hyperstimulation syndrome (OHSS).

When the aging factor is combined with PCOS, the challenge becomes even more severe. Today, Tulip International Reproductive Center will systematically solve the dilemma of "more eggs obtained, fewer good embryos" for PCOS patients in IVF through a real successful case and Q&A format.

Q1: What is Polycystic Ovary Syndrome (PCOS)? Why does it often appear as "more eggs retrieved and fewer good embryos" in IVF?

A: Polycystic ovary syndrome is a common endocrine and metabolic disorder that affects women of childbearing age. Its core features are ovulation dysfunction and excessive levels of testosterone in the body. Under ultrasound, the ovaries usually present many small follicles that cannot develop and mature normally, known as "polycystic changes".

The typical dilemma faced by PCOS patients in IVF is that they have more eggs but fewer good embryos. The scientific reasons behind this dilemma mainly include:

Poor follicular development environment: PCOS patients have a complex endocrine disorder in their bodies for a long time, especially hyperandrogenism and hyperinsulinemia. This environment can interfere with the normal growth of follicles and the maturation process of eggs, resulting in a higher proportion of immature eggs (MI eggs) or empty follicles even if many eggs are retrieved.

Egg quality damage: This imbalanced endocrine environment can cause oxidative stress damage to the egg, which may affect the developmental maturity of its cytoplasm and nucleus, leading to lower fertilization rates, lower blastocyst formation rates, and increased risk of chromosomal abnormalities in the embryo.

Q2: What is the biggest risk for PCOS patients undergoing in vitro fertilization treatment?

A: The biggest risk is ovarian hyperstimulation syndrome (OHSS). Due to the large number of basal follicles in the ovaries of PCOS patients, they are highly sensitive to ovulation inducing drugs. If the dosage or timing of the ovulation induction program is not properly controlled, the ovaries will overreact, leading to the overgrowth of multiple follicles and a sharp increase in estrogen levels in the body.

This may lead to a series of serious complications, ranging from mild bloating and nausea to severe conditions such as pleural effusion, ascites, blood concentration, vascular embolism, and even life-threatening situations. Therefore, for PCOS patients, the primary principle of IVF treatment is to prioritize safety while ensuring effectiveness.

Q3: Can you share a successful case of Tulip International Reproductive Center helping elderly PCOS patients overcome these challenges?

A: Of course. Ms. Zhang, who is 38 years old, is a typical elderly PCOS patient with an AMH value as high as 9.8 ng/ml.

Past failure experience: Before finding us, Ms. Zhang had experienced a failed IVF cycle at another center. At that time, 22 eggs were retrieved from her, which seemed to be an impressive number, but ultimately only 4 blastocysts were formed. After PGT genetic testing, only one blastocyst with a quality rating of 4BC passed the screening and failed to implant successfully after transplantation. This experience has raised great doubts about the quality of her eggs.

The cycle results of tulips:

Egg retrieval result: We retrieved 18 eggs for her, including 15 mature eggs (MII).

Fertilization and blastocyst cultivation: Out of 15 mature eggs, 14 were fertilized normally, resulting in the successful cultivation of 10 high-quality blastocysts.

PGT results: 10 blastocysts were sent for testing, and ultimately 5 completely normal embryos passed the screening with a screening rate of up to 50%, including top-level blastocysts rated as 4AA and 4AB.

This result not only far exceeded her previous cycle in terms of quantity and quality, but more importantly, Ms. Zhang did not show any symptoms of OHSS throughout the entire treatment process and completed the treatment safely and smoothly.

Q4: How did Tulip International Reproductive Center solve the problem for this patient and achieve high blastocyst rate and high screening rate?

A: The key to success lies in a personalized solution that prioritizes safety and is precise and efficient.

Adopting the PPOS protocol to control risks from the source: We chose the PPOS (ovulation induction under high progesterone status) protocol for Ms. Zhang. Oral administration of progesterone (such as progesterone) throughout ovulation induction can effectively inhibit the endogenous luteinizing hormone (LH) peak and prevent premature ovulation of follicles. More importantly, this approach can significantly reduce the risk of OHSS and provide a solid safety barrier for PCOS patients.

Using safe night shots to ensure egg quality: In the final step of follicle maturation, we used a dual drug combination of Aize (recombinant hCG) and GnRHa (gonadotropin-releasing hormone agonist) as the trigger (night shot). GnRHa can simulate the natural LH peak in the human body, gently promote the final maturation of eggs, and has a short duration of action, further reducing the risk of OHSS. Low doses of hCG can provide better support for cumulus cells.

Top tier embryo laboratory technology, maximizing embryo potential: High quality clinical plans require powerful laboratories to undertake. The embryo laboratory of Tulip International Reproductive Center provides the best development environment for each fertilized egg through advanced culture medium system and strict quality control standards, thus raising Ms. Zhang's blastocyst formation rate and high-quality blastocyst rate to a new height, laying a solid foundation for the subsequent high screening rate.

Polycystic ovary syndrome (PCOS) is not a "terminal disease" of infertility, and its challenges in IVF are by no means unsolvable. Through cutting-edge clinical strategies such as the PPOS program, combined with top-notch embryo laboratory technology, it is entirely possible to achieve the dual goals of "safe expulsion" and "high-quality embryos".

At Tulip International Reproductive Center, we are committed to tailoring the most suitable plan for every PCOS patient, solving the problem of "getting more eggs and fewer good embryos", and making your journey to conceive safer and more efficient.

For fertility consultation in Kyrgyzstan, please contact your dedicated consultant

/Fertility Consultation /

Dr.Chan

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