Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Öz

Objective: The gonadotropin-releasing hormone-agonist (GnRH-a) treatment during in vitro fertilization (IVF) sometimes causes a functional ovarian cyst during the administration period before gonadotropin stimulation, as an undesired event. The aim of this study was to analyze the effect of these cysts on the IVF outcomes. Materials and Methods: Out of 981 IVF cycles, 78 with ovarian cysts were retrospectively analyzed with respect to the demographic characteristics, hormonal outcomes, and fertilization, implantation and clinical pregnancy rates. Results: The metaphase II oocyte ratio, fertilization rate and percentage of high quality embryos (grade 1) were significantly higher in the cyst-negative group (p<0.0001; p<0.0001; p≤0.05). These same three parameters were also significantly higher in the cyst-aspirated group (p<0.01; p<0.05; p<0.05). Cyst diameters of the aspiration group were significantly higher (p<0.05). No statistically significant differences in implantation and clinical pregnancy rates were determined between the groups. Conclusion: An ovarian cyst formation during the GnRH-a suppression period negatively affects oocyte quality. Cyst aspiration before gonadotropin stimulation does not improve the IVF outcome. Turkish Başlık: IVF Sikluslarında GnRH Agonist Tedavisi Sonrası Oluşan Over Kistleri Oosit Kalitesini Düşürür Anahtar Kelimeler: Over kisti,IVF,GnRH agonisti Amaç: In vitro fertilizasyon (IVF) sürecinde, kontrollü ovaryen stimülasyon öncesinde kullanılan gonadotropin-releasing hormone-agonist (GnRH-a) tedavisi, zaman zaman, istenmeyen bir etki olarak, ovaryen kist oluşumuna neden olabilir. Bu çalışmamızda, GnRH-a oluşan bu kistlerin, IVF sonuçlarına etkisini araştırdık. Gereç ve Yöntemler: Toplam 931 IVF siklusu içinde, GnRH-a sonrası kistespit edilen 78 hasta, demografik özellikler, hormonal sonuçlar, fertilizasyon, implantasyon ve gebelik hızları açısından, retrospektif olarak analiz edilidi. Bulgular: Metafaz II oosit oranı, fertilizasyon hızı ve yüksek kalitedeki embiryo yüzdesi, kist olmayan hasta grubunda, anlamlı olarak daha yüksek tespit edildi (p<0.0001; p<0.0001; p≤0.05). Ayrıca, bu üç parametre, kist aspirasyonu yapılan grupta, aspirasyon işlemi yapılmayan gruba oranla, anlamlı olarak daha yüksek belirlendi (p<0.01; p<0.05; p<0.05). Kist çapı, aspirasyon yapılan grupta, anlamlı olarak daha yüksekti (p<0.05). İmplantasyon ve klinik gebelik hızları açısından, gruplar arasında herhangi bir fark tespit edilemedi. Sonuç: GnRH-a süpresyon periyodu sonrası oluşan ovaryen kistler, oosit kalitesini kötü yönde etkileyebilir. Gonadotropin stimülasyonu öncesi kistin aspire edilmesinin, IVF başarısına bir katkı sağlamaz.

Anahtar Kelimeler

• Ovarian cyst, in vitro fertilization (IVF), gonadotropin-releasing hormone agonist

Ovarian Cyst Formation Following Gonadotropin-Releasing Hormone-Agonist Administration Decreases the Oocyte Quality in IVF Cycles

Öz

Kaynakça

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