Early follicle development disrupted in polycystic ovaries
Source: Lancet 2003; 362: 1017-21
Investigators examine patterns of follicular development in polycystic and normal ovaries.
Abnormalities leading to anovulation in women with polycystic ovaries appear to occur at the earliest stages of follicular development, researchers report.
"Polycystic ovary syndrome is the most common endocrine abnormality in women of reproductive age and is the main cause of anovulatory infertility," comment Dr. S. Franks (Imperial College, London, UK) and colleagues. Abnormalities of follicular maturation are observed in these patients, "but whether there is an intrinsic abnormality of ovarian folliculogenesis remains unclear."
To investigate, Franks et al examined cortical biopsies from 32 women with polycystic ovaries, 16 of whom also had oligomenorrhea, and 24 women with normal ovaries and regular menstrual cycles. Computerized image analysis was used to assess follicle development and survival.
The median density of preantral follicles was six times greater in the anovulatory women with polycystic ovaries than the controls. In both ovulatory and anovulatory women with polycystic ovaries, there was a significant increase in the percentage of primary follicles and a corresponding decrease in the proportion of primordial follicles compared with the normal ovaries.
"Our findings indicate that there are fundamental differences between polycystic and normal ovaries in early follicular development, suggesting an intrinsic ovarian abnormality," the researchers conclude
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Early follicle development disrupted in polycystic ovaries 
