Optimizing Oocyte Quality in Polycystic Ovary Syndrome (PCOS): The Impact of Neurotrophin-4 in In Vitro Maturation Protocols
Abstract
ABSTRACT A 28-year-old female with polycystic ovary syndrome (PCOS) and a history of primary infertility for eight years underwent in vitro maturation (IVM) at Wardha. The patient’s clinical profile revealed elevated levels of anti-Müllerian hormone (AMH) levels, a high luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio, and ultrasound findings consistent with PCOS. After mild ovarian stimulation, 12 immature oocytes were retrieved and cultured in Neurotrophin-4 (NT-4) enriched IVM medium. A total of eight oocytes matured to the metaphase II stage, with seven achieving fertilization via intracytoplasmic sperm injection (ICSI). Out of the fertilized oocytes, five developed into high-quality blastocysts. The patient received an optimized endometrial preparation protocol, including metformin, estradiol, cabergoline, and L-arginine supplementation. Following frozen embryo transfer, pregnancy was confirmed by positive beta-human chorionic gonadotropin (β-hCG) levels and ultrasound. This study highlights IVM’s potential to mitigate ovarian hyperstimulation syndrome (OHSS) risks while achieving high success rates in PCOS patients. The inclusion of NT-4 in maturation media significantly improved oocyte quality, fertilization rates, and blastocyst development. These findings underscore IVM as a promising assisted reproductive technology (ART) approach, offering enhanced safety and efficacy for fertility treatment in PCOS patients.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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