title: [Concentration of steroid hormones in the follicular fluid of mature and immature ovarian follicles of patients with polycystic ovary syndrome submitted to in vitro fertilization].
abstract: OBJECTIVE
  to evaluate the concentration of steroid hormones in follicular fluid (FF) of small (10-14 mm) and large (> 18 mm) follicles of women with polycystic ovary syndrome (PCOS) submitted to controlled ovarian hyperstimulation (COH) and in vitro fertilization (IVF) cycles.
  
  
  METHODS
  a case-control study was conducted on 13 infertile women with PCOS (17 cycles) and 31 infertile women due to male factor - Control Group (31 cycles). FF was aspirated individually and divided into four groups: G1 (FF of small follicles of the Control Group), G2 (FF of small follicles of the PCOS group), G3 (FF of large follicles of the Control Group) and G4 (FF of large follicles of the PCOS group). Estrogen, progesterone and β-hCG were determined by chemiluminescence, and testosterone and androstenedione by radioimmunoassay. The unpaired t-test was used to compare the hormone determinations in the FF of the PCOS and Control Groups, and the four groups were compared by ANOVA. Fisher's exact test was used to compare the pregnancy rates.
  
  
  RESULTS
  the small follicles of the two groups had lower progesterone levels (8,435 ± 3,305 ng/mL) than large follicles (10,280 ± 3,475 ng/mL), p-value <0.01. The progesterone levels of all follicles of group PCOS (8,095 ± 4,151 ng/mL) were lower than Control (9,824 ± 3,128 ng/mL), p-value =0.03. Testosterone differed between G1 (326.6 ± 124.4 ng/dL) and G3 (205.8 ± 98.91 ng/dL), p-value <0.001, and between G3 (205.8 ± 98.91 ng/dL) and G4 (351.10 ± 122.1 ng/dL), p-value <0.001. Small follicles had higher testosterone levels (508.9 ± 266 ng/dL) than large follicles (245.10 ± 123 ng/dL), p-value <0.0001. The pregnancy rates did not differ between the PCOS (5/13, 38.5%) and the Control groups (9/31, 40.9%), p-value =072.
  
  
  CONCLUSIONS
  women with PCOS had high testosterone concentrations in the FF, regardless of the stage of follicle development, and reduced progesterone levels, suggesting that paracrine factors may inhibit the secretion of the latter by follicular cells. The pregnancy rates showed that treatment with COH and IVF is a good option for women with infertility secondary to PCOS.
authors.affiliation: Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo – USP – Ribeirão Preto (SP), Brasil.
authors.forename: Luciana Ochuiuto Teixeira
authors.initials: LO
authors.lastname: de Resende
authors.forename: Rosana Maria
authors.initials: RM
authors.lastname: dos Reis
authors.forename: Rui Alberto
authors.initials: RA
authors.lastname: Ferriani
authors.forename: Alessandra Aparecida
authors.initials: AA
authors.lastname: Vireque
authors.forename: Laura Ferreira
authors.initials: LF
authors.lastname: Santana
authors.forename: Ana Carolina Japur
authors.initials: AC
authors.lastname: de Sá Rosa e Silva
authors.forename: Wellington de Paula
authors.initials: Wde P
authors.lastname: Martins
mesh_terms: D000328:Adult; D000735:Androstenedione / Q000032:analysis; D016022:Case-Control Studies; D004958:Estradiol / Q000032:analysis; D005260:Female; D005307:Fertilization in Vitro; D015571:Follicular Fluid / Q000737:chemistry*; D006801:Humans; D006080:Ovarian Follicle / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000473:pathology; D011374:Progesterone / Q000032:analysis; D013739:Testosterone / Q000032:analysis
chemical_list: D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol