Embryo Quality and Intracytoplasmic Sperm Injection (ICSI) Outcome in Iraqi Women with Polycystic Ovary Syndrome (PCOS): A Cohort Prospective Study

Polycystic ovary syndrome (PCOS) is a major cause of ovulatory dysfunctions among reproductive-aged women. PCOS impairs folliculogenesis leading to suboptimal oocyte maturation, impaired embryonic development and pregnancy failure. Intracytoplasmic sperm injection (ICSI) is a popular option for PCOS patients to attain pregnancy. However, there is no specific determinant to ascertain successful pregnancy outcome in PCOS women undergoing ICSI. The purpose of this study was to determine the influence of PCOS on embryo quality and subsequent pregnancy rate in Iraqi women who had undergone ICSI. Over the course of three months, one hundred and three infertile couples who were referred to Al-Sadr Medical City, Kufa, Iraq between October 2017 and June 2018 were enrolled in this study. The couples were divided into two groups: those with PCOS, and those who did not have PCOS. The amounts of hormones were determined. The evaluation of embryo attributes with grading, as well as the determination of the fertilization rate, cleavage rate, and pregnancy rate, were carried out. The difference in fertility and cleavage rates between the PCOS (P=0.40) and non-PCOS (P=0.59) groups was not statistically significant. When comparing the two groups, the mean number of good quality embryos in the PCOS group was higher (P=0.07), whereas the pregnancy rate in the former was considerably lower (P=0.02) than in the latter. According to our findings, PCOS had no negative impact on the quality of the embryos produced by Iraqi women who underwent ICSI treatment. Because PCOS is a complicated disorder characterized by a variety of endogenous physiological variables that may either directly or indirectly interfere with conception, the low likelihood of pregnancy in these patients suggests that good embryo quality is not the only predictor of successful pregnancy.