Abstract
OBJECTIVE: To establish the ovarian preantral follicular developmental patterns of women with polycystic ovarian syndrome (PCOS) and those with normal ovaries. DESIGN: Prospective observational study. MATERIALS AND METHODS: IRB approval was obtained. Patients were undergoing surgery for other gynecologic reasons. Subjects with PCOS, meeting all three Rotterdam criteria, were recruited. Normal controls were normal cycling, without diabetes or hyperandrogenism, had no evidence of PCO morphology on ultrasound, and had not used any hormonal therapy in the preceding six months. Ovarian cortex biopsies were obtained. Biopsy samples underwent enzymatic digestion and follicle release in a mixture of Collagenase Type IA and DNase. All follicles were microscopically assessed and classified by a single investigator (TWM) according to preantral follicular developmental stage (primordial, transitional, primary, secondary, multilaminar). RESULTS: Three patients with classic PCOS and five normal controls were analyzed. Groups did not differ by age, however the PCOS group had a significantly higher BMI compared with controls (40.0 vs 22.9). A total of 5,904 follicles were analyzed, 3,171 from normal controls, and 2,733 from PCOS. Follicle distributions according to stage are shown in the table. Multinomial logit modeling was used to compare the proportions at each stage. All stage distributions were similar with no significant variation between normals and those with PCOS.Tabled 1Ovarian Preantral Follicle DistributionNormal n=3171PCOS n=2733Primordial1382 (43.6)1317 (48.2)Transitional1242 (39.2)765 (28.0)Primary432 (13.6)482 (17.6)Secondary86 (2.7)131 (4.8)Multilaminar27 (0.9)29 (1.1)Antral22 (0.1)9 (0.3)All comparisons non-significant. Open table in a new tab All comparisons non-significant. CONCLUSION: In this large analysis of preantral follicles, we found that there is no difference in the pattern of early ovarian follicular growth among normal women or those with PCOS.
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