In-vitro ovarian steroidogenesis in women with pelvic congestion

Follicular fluid steroid content and theca and granulosa cell steroidogenes is in pelvic congestion cystic ovaries were compared with steroidogenic fun ction in both normal and polycystic ovaries. Ovaries were obtained at oopho rectomy for benign gynaecological conditions, and classified according to g ross morphology at dissection. Individual follicles were dissected out, fol licular fluid aspirated, and granulosa and theca cells cultured in vitro. A ndrostenedione, progesterone and oestradiol content of the follicular fluid and overlying culture medium were measured by radioimmunoassay,There was a significant elevation of both basal and LH-stimulated androstenedione prod uction by theca from both polycystic ovaries (a = 10; P < 0.005) and pelvic congestion cystic ovaries (n = 8; P < 0.05 and < 0.01 respectively) as com pared with normal ovaries (n = 5), Granulosa cells from pelvic congestion o varies (n = 7) had a diminished oestradiol response to FSH as compared with those from normal ovaries (n = 8), Follicular fluid from the majority of f ollicles in the pelvic congestion cystic ovaries had a high androgen:oestro gen ratio consistent with atresia, For the first time, pelvic congestion ov aries characterized by predominantly atretic follicles scattered throughout the stroma in a normal volume ovary are reported, Follicular atresia was r eflected by reduced granulosa cell responsiveness to FSH, theca cell hyperp lasia and increased basal and LH-stimulated androgen production. These ovar ies are functionally distinct from polycystic ovaries, which do not have a higher proportion of atretic follicles than normal ovaries.