OOCYTE QUALITY IN POLYCYSTIC OVARIES REVISITED - IDENTIFICATION OF A PARTICULAR SUBGROUP OF WOMEN

Purpose: Our purpose was to assess the endocrine status of women with polycystic ovaries (PCO) undergoing IVF, and to compare oocyte quality with endocrine markers of the syndrome, in an attempt to define a sub population with poor quality oocytes. Methods: This was a retrospectiv e study. Patients were first endocrinologically analyzed: serum levels of androgens (T, androstenedione, DHEAS), FSH, and LH as well as gluc ose and insulin after an oral glucose tolerance test (OGTT) were recor ded and are expressed as absolute values and area under the curve (AUG ). Subsequently, they were followed over a 2-year period in which pati ents underwent several attempts of IVF as well as serving as oocyte do nors. Patients were divided into three groups: group I (n = 4) was wom en who displayed embryos unable to implant in 15 IVF cycles and 10 ovu m donation cycles in which they served as donors; group II (n = 16) wa s PCO patients in whom IVF (n 38) and/or oocyte donation cycles (n = 4 2) resulted in pregnancies; and group III (n = 13) was IVF patients wi th normal appearance of the ovaries by ultrasound. The endocrine statu s was compared with the IVF results. Results: There was no difference among groups in the endocrinological parameters rested, except for the OGTT which identified women in group las having higher serum glucose and insulin levels than patients in groups II and III; Similarly, the OGTT showed higher serum glucose values in group II compared to group III. Women in group I were also obese, Patients in group III were olde r than PCO patients and needed more gonadotropins to reach an ovarian response which resulted in a reduced number of oocytes retrieved. Fert ilization was also impaired in group I, in which no pregnancy was reco rded. Conclusions: This study shows that there is a particular subgrou p of PCO patients with lower fertilization rates and embryos unable to implant. These patients are obese and nonhyperandrogenic and show der angements of insulin secretion.