title: Prolonged survival in culture of preantral follicles from polycystic ovaries.
abstract: BACKGROUND
  In polycystic ovary syndrome (PCOS), an increased proportion of follicles leave the primordial (resting) pool and initiate growth. However, there is little evidence for a reduced reproductive life span (early menopause) in women with PCOS, suggesting that the dynamics of follicle growth, and of follicle loss by atresia, is altered in PCOS.
  
  
  OBJECTIVE
  The aim of this study was to investigate the possibility that loss of preantral follicles by atresia is reduced in PCOS, leading to prolonged follicle survival.
  
  
  METHODS
  We compared follicle growth in normal and polycystic ovaries using cultures of small ovarian biopsies.
  
  
  METHODS
  Tissue samples were obtained at routine laparoscopy from 12 patients with anovulatory PCOS and 16 controls and processed in an ovarian physiology laboratory.
  
  
  METHODS
  We performed morphometric analysis of follicle population in tissue fixed at time of biopsy (d 0) or after 5, 10, or 15 d in culture. Analyses included assessment of follicle and oocyte diameter, number and proportion of primordial and growing follicles, and number and proportion of atretic follicles.
  
  
  RESULTS
  In tissue fixed on d 0, the proportion of healthy growing follicles was, as expected, greater in ovaries from PCOS patients than in normal ovaries (64 vs. 28%; P = 0.0005), but there were no differences between PCOS and normal tissue during culture. The rate of atresia throughout the period of culture in follicles was, however, significantly lower in PCOS tissue (P < 0.0001). After culture, 80% of follicles in normal ovarian tissue were atretic compared with 53% in PCOS biopsies.
  
  
  CONCLUSIONS
  Follicles from polycystic ovaries demonstrate a decreased rate of atresia in culture, suggesting a mechanism for maintaining a larger follicle pool throughout reproductive life.
authors.affiliation: Imperial College School of Medicine, Institute of Reproductive and Developmental Biology, Hammersmith Hospital, Du Cane Road, London W12 0NN, United Kingdom.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Webber
authors.forename: Sharron A
authors.initials: SA
authors.lastname: Stubbs
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Stark
authors.forename: Raul A
authors.initials: RA
authors.lastname: Margara
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Trew
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Lavery
authors.forename: Kate
authors.initials: K
authors.lastname: Hardy
authors.forename: Stephen
authors.initials: S
authors.lastname: Franks
mesh_terms: D000328:Adult; D002470:Cell Survival / Q000502:physiology; D002478:Cells, Cultured; D005260:Female; D005496:Follicular Atresia / Q000502:physiology; D006801:Humans; D010535:Laparoscopy; D006080:Ovarian Follicle / Q000473:pathology*; D011085:Polycystic Ovary Syndrome / Q000473:pathology*; D046509:Tissue Culture Techniques