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Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence

1 , * , 2 , *

Human Reproduction Update

Oxford University Press

polycystic ovary syndrome, oocyte, fertilization, embryo, IVF

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      Abstract

      BACKGROUND

      Polycystic ovary syndrome (PCOS) is a common metabolic dysfunction and heterogeneous endocrine disorder in women of reproductive age. Although patients with PCOS are typically characterized by increased numbers of oocytes retrieved during IVF, they are often of poor quality, leading to lower fertilization, cleavage and implantation rates, and a higher miscarriage rate.

      METHODS

      For this review, we searched the database MEDLINE (1950 to January 2010) and Google for all full texts and/or abstract articles published in English with content related to oocyte maturation and embryo developmental competence.

      RESULTS

      The search showed that alteration of many factors may directly or indirectly impair the competence of maturating oocytes through endocrine and local paracrine/autocrine actions, resulting in a lower pregnancy rate in patients with PCOS. The extra-ovarian factors identified included gonadotrophins, hyperandrogenemia and hyperinsulinemia, although intra-ovarian factors included members of the epidermal, fibroblast, insulin-like and neurotrophin families of growth factors, as well as the cytokines.

      CONCLUSIONS

      Any abnormality in the extra- and/or intra-ovarian factors may negatively affect the granulosa cell–oocyte interaction, oocyte maturation and potential embryonic developmental competence, contributing to unsuccessful outcomes for patients with PCOS who are undergoing assisted reproduction.

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            Author and article information

            Affiliations
            [1 ]Department of Obstetrics and Gynecology, simplePeking University Third Hospital , Beijing 100083, People's Republic of China
            [2 ]Department of Obstetrics and Gynecology, simpleNorth Shore University Hospital , NYU School of Medicine, Manhasset, NY 11030, USA
            Author notes
            *Correspondence address. Fax: +1-516-562-1754; E-mail: hfeng@ 123456nshs.edu (H.L.F.)/Fax: +1-86-10-62013283; E-mail: jie.qiao@ 123456263.net (J.Q.)
            [†]

            Two equal first authors.

            Journal
            Hum Reprod Update
            humupd
            humupd
            Human Reproduction Update
            Oxford University Press
            1355-4786
            1460-2369
            Jan-Feb 2011
            16 July 2010
            16 July 2010
            : 17
            : 1
            : 17-33
            3001338
            20639519
            10.1093/humupd/dmq032
            dmq032
            © The Author 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. For Permissions, please email: journals.permissions@oxfordjournals.org

            This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/2.5) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited

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            Human biology

            ivf, oocyte, embryo, polycystic ovary syndrome, fertilization

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