Reproductive Biology and Endocrinology recently published an online article authored by Dr. Alex Kotlyar and Dr. David Seifer: “Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes”
PCOS is a complex syndrome. For patients with PCOS that are planning IVF, this article reviews the essential steps based upon the most recent literature that need to be taken before an IVF cycle, during an IVF cycle, and after an IVF cycle. The steps outlined in this peer-reviewed article are meant to optimize not just the success of IVF for patients with PCOS, but also the safety of patients with this condition.
Even before IVF has been planned, a proper assessment should be taken to optimize IVF cycle outcomes in a patient with PCOS. These include lifestyle modification, cycle priming and various adjuvants i.e. supplements/ medications that could address aspects of PCOS pathophysiology. Elevated age-specific AMH levels, decreased vitamin D levels and elevated BMI (≥ 30) provide insight into choosing metformin pretreatment and/or vitamin D supplementation. During IVF, choosing the optimal method of ovarian stimulation and triggering method are essential in lowering chances of OHSS and maximize egg yield.