ISOLATED POLYCYSTIC MORPHOLOGY IN OVUM DONORS PREDICTS RESPONSE TO OVARIAN STIMULATION

The isolated finding of polycystic-appearing ovaries on ultrasound examination of normal women is not uncommon, The purpose of this study was to determine the clinical significance of polycystic ovaries in a population of healthy, non-hirsute, fertile women preparing to undergo ovarian stimulation, We evaluated whether the finding of polycystic ovaries in oocyte donors predicts a different response to ovarian stimulation when compared to donors with normal-appearing ovaries, Furthermore, we examined whether oocytes from polycystic ovaries had the same capacity for fertilization and development as those retrieved from normal ovaries, In all, 11 donors with polycystic-appearing ovaries were compared prospectively to 13 donors with normal-appearing ovaries who were undergoing ovarian stimulation during the same time interval, The two groups were similar in age and baseline androgen concentrations, Significantly more oocytes were produced by the polycystic group for the amount of human menopausal gonadotrophin (HMG) administered (P < 0.05), In addition, all previous cycles completed by these 24 donors were compared (polycystic group: total of 31 cycles; normal group: total of 37 cycles), The donors with polycystic ovaries required less HMG to obtain optimal stimulation (P < 0.05), attained a greater peak oestradiol concentration (P < 0.05), produced a greater number of follicles (P < 0.05) and oocytes (P < 0.01) and a higher percentage of mature oocytes (P < 0.05), Furthermore, they achieved a higher peak oestradiol/HMG (P < 0.01) and oocytes/HMG ratio (P < 0.01), Also, the oocytes from donors with polycystic-appearing ovaries, in contrast to reports of oocytes from women with polycystic ovary syndrome, demonstrated superior maturity (P < 0.05) and similar fertilization, clinical pregnancy and miscarriage rates as oocytes from normal-appearing ovaries, In conclusion, visualizing polycystic ovaries in normal women predicts a heightened sensitivity to HMG, Nonetheless, women with polycystic-appearing ovaries are excellent oocyte donors, producing significantly more oocytes than donors with normal-appearing ovaries, Furthermore, the oocytes collected are of normal quality and have the same capacity for fertilization and embryo development.