In-vitro fertilization outcomes in females of advanced maternal age with polycystic ovarian syndrome

Abstract

This study aimed to evaluate in vitro fertilization (IVF) outcomes in women of advanced maternal age (≥35 years) diagnosed with polycystic ovarian syndrome (PCOS), compared with age-matched women without PCOS. Given that advancing age is associated with declining ovarian reserve and fertility potential, this research sought to determine whether the hormonal and ovarian characteristics of PCOS confer any advantage in IVF outcomes within this population.

A retrospective quantitative analysis was conducted using data from 174 IVF cycles performed at an Assisted Reproductive Technology (ART) Clinic at the main public hospital in Malta between January 2021 and 2024. Key outcome measures included oocyte yield, number of embryos generated, clinical pregnancy rates, and viable pregnancy rates at 12 weeks of gestation.

Women with PCOS demonstrated significantly higher serum anti-Mullerian hormone (AMH) levels and oocyte yields, alongside increased embryo numbers and clinical pregnancy rates, compared with non-PCOS counterparts. However, viable pregnancy rates at 12 weeks did not differ significantly.

While further research can improve practice, it is evident that clinicians should provide individualised fertility counselling and design tailored ovarian stimulation protocols for women with PCOS of advanced maternal age to optimize treatment outcomes while mitigating the risk of early pregnancy loss.