Premature luteinization and in vitro fertilization outcome in gonadotropin/gonadotropin-releasing hormone antagonist cycles in women with polycystic ovary syndrome

Objective: To determine the incidence of premature luteinization in patients with polycystic ovary syndrome (PCOS) undergoing controlled ovarian hyperstimulation (COH) with exogenous gonadotropin/GnRH antagonist (GnRH-a); to compare clinical outcomes in patients with and without premature luteinization. Design: Retrospective case series. Setting: IVF clinic. Patient(s): Thirty-five treatment cycles in 30 patients with PCOS. Intervention(s): Controlled ovarian hyperstimulation with gonadotropin/GnRH-a protocol. Main Outcome Measure(s): Premature luteinization defined as a P concentration of >= 1.3 ng/mL on the day of hCG administration; number of oocytes and two pronuclei (2PN) embryos; implantation and clinical pregnancy rates (PR). Result(s): The incidence of premature luteinization was 28%. Compared with those without premature luteinization, patients with premature luteinization had a higher number of oocytes retrieved (24.1 +/- 13.3 vs. 12.0 +/- 5.9) and greater number of mature oocytes (19.7 +/- 11.7 vs. 9.5 +/- 4.5), respectively. The number of good quality embryos and embryos transferred was not significantly different between groups. Although implantation rates (56% vs. 40%) and clinical PRs (36% vs. 30%) were higher in patients without premature luteinization, the differences were not statistically significant. Conclusion(s): The patients with PCOS with premature luteinization had a higher number of oocytes retrieved and mature oocytes, and similar clinical PRs as patients with PCOS without premature luteinization. (Fertil Steril (R) 2009;91:1755-9. (C)2009 by American Society for Reproductive Medicine.)