Subacute inflammatory reaction in follicular fluid of Chinese PCOS patients

AIM: To retrospectively analyze the lipid metabolism disturbance and subacute inflammation within the microenvironment of follicular fluid between Chinese polycystic ovarian syndrome(PCOS) patients and the controls.METHODS: Serum lipid indexes, steroid hormone levels, and inflammatory cell counts were analyzed. The inflammatory cytokine and apolipoprotein levels were detected in the serum and follicular fluid. The mRNA expression of apolipoproteins and cytokines in the granulose cells was determined by real-time PCR.RESULTS: PCOS patients showed typical obesity accompanied with hyperlipidemia and hyperandrogenemia. Significantly elevated inflammatory cell number and cytokine levels were detected in both serum and follicular fluid. The mRNA expression levels of the inflammatory cytokines and apolipoproteins in the granulose cells from the PCOS patients were higher than those from the controls.CONCLUSION: Elevated apolipoproteins reflect systematic hyperlipidemia in the follicular fluid. Serum lipids and cytokines penetrate follicle-serum barrier and get into follicle fluid. Meanwhile, increased intake of apolipoproteins or elevated synthesis of cytokines(IL-1, IL-6 and TNF-α) by granulose cells could also be crucial to stabilize microenvironment of follicular fluid. Oocyte and subsequent embryos are sensitive to the originaal follicular environment. The lipid metabolism disturbance, inflammatory cell infiltration and hyperandrogenemia may possibly disturb oocyte developmental potential.