Comparison of follicle steroidogenesis from normal and polycystic ovaries in women undergoing IVF: relationship between steroid concentrations, follicle size, oocyte quality and fecundability

Studies of ovarian stimulation for IVF have suggested a relationship betwee n follicle size and pregnancy rates. Furthermore the follicular endocrine e nvironment is correlated with oocyte quality. The aim of this study was fir st to verify the relationship between follicular steroid content, follicula r size, oocyte maturity and fertilization outcome in women with normal ovar ies following recombinant human FSH (rhFSH). Secondly this study was extend ed to women with polycystic ovarian syndrome (PCOS), Fifty-nine patients (3 1 normal, 28 PCOS) underwent conventional IVF with rhFSH induction. Follicu lar diameter was classified as small (8-13 mm) or large (>14 mm) and sex st eroid content was analysed for each group. Oocyte maturity was studied acco rding to nuclear maturation the day after fertilization. In both ovulation groups, 17 beta -oestradiol and progesterone concentration were significant ly higher in large follicles with meiotically competent oocytes compared wi th those containing meiotically incompetent oocytes. Testosterone levels we re increased in PCOS follicles compared with normal patients, with no diffe rence between corresponding sub-groups of follicles with meiotically compet ent oocytes. The relationship between follicle size and embryo development showed that 14 mm could be a threshold value following rhFSH induction in n ormal or PCOS women.