Association of Follicular Distribution Patterns in Polycystic Ovaries with Clinical Outcomes in Assisted Reproductive Technology Cycles: A Prospective Cohort Study.

Background: This study aims to evaluate the crucial relationship between the follicular distribution pattern (FDP) in polycystic ovaries and its impact on reproductive outcomes. Recognizing these correlations is essential for optimizing assisted reproductive treatments and improving fertility outcomes in polycystic ovary syndrome (PCOS) patients.

Materials and methods: This prospective cohort study included women diagnosed with PCOS who were referred for IVF/ICSI treatment at the Arash Women's Hospital. Patient screening was conducted between March 2022 and September 2023. Ultrasound imaging was performed on cycle days 2-3 of either natural menstrual cycles or those induced by progestin to assess follicular distribution and ovarian characteristics. Ovarian ultrasound images were classified based on the Rotterdam criteria. The association between the FDP and the menstrual status, luteinizing hormone (LH) and Anti-Müllerian hormone (AMH) levels, as well as total number of retrieved and metaphase II oocytes and the rate of ovarian hyperstimulation syndrome (OHSS) at risk were evaluated.

Results: Of the 157 PCOS patients evaluated during the study period, 73 patients were classified in the peripheral cystic pattern (PCP) ovaries group and 84 patients in the general cystic pattern (GCP) ovaries group. There was no statistically significant difference in age and body mass index between groups. The mean serum levels of LH, AMH, total testosterone, and 17-OHP in the PCP group were significantly higher than the GCP group (P=0.022, P=0.023, P<00.001, and P=0.028, respectively). The number of retrieved oocytes and the OHSS at risk rate in the PCP group were notably greater than the GCP group.

Conclusion: Myomectomy may lead to a significant decrease in AMH levels in women with uterine leiomyoma undergoing both open and laparoscopic myomectomies, and the size and type of myoma significantly affects the changes in the hormone.