Endocrine Abstracts

Introduction: Polycystic Ovary Syndrome (PCOS) is a very common endocrinopathy affecting 6 to 13% of women of reproductive age and one of the leading causes of female poor fertility. It was initially defined by the association of anovulation and clinical and/or biochemical hyperandrogenism (1990 National Institutes of Health-sponsored conference). Since Rotterdam ESHRE/ASRM Consensus Conference in 2003, polycystic ovaries morphology on ultrasound (ECHO condition) was added as a supplementary diagnostic criterion, although not mandatory. Indeed, PCOS is currently defined by at least two of the three features mentioned above. Despite some discordant results, ECHO condition seems to be associated with higher levels of androgens and major insulin resistance. Further, a large number of ovarian follicles is a known risk factor of ovarian hyperstimulation syndrome during a Medically Assisted Reproduction (MAR) procedure.

Objective: Since adipokines role in reproductive function is well known, the aim of our study was to characterise the ovarian mRNA expression of some adipokines and their receptors in PCOS women and compare it with the ECHO condition.

Methods: PCOS patients (n=20) were compared to women presenting ECHO condition (n=19) or another infertility cause requiring a MAR procedure (n=22). Each group equally included normal weight (BMI 18–25 kg/m²) and obese (BMI > 30 kg/m²) women. Adipokines expression was studied both in follicular fluid (ELISA) and granulosa cells (qPCR) obtained during the oocyte retrieval preceding in vitro fertilisation. Hormonal profile and reproduction outcomes were also collected for all patients.

Results: Ovarian expression of all adipokines varied according to weight profile, with chemerin, resistin, visfatin, omentin and apelin levels higher in obese patients. Compared to controls, PCOS women presented a higher expression of chemerin, apelin and omentin (P<0.001), while ECHO group was characterised by lower levels of omentin (P<0.01). Same results were found in follicular fluid and granulosa cells. Interestingly, compared to PCOS group, ECHO women had a greater number of mature oocytes and embryos (P<0.01) and lower concentrations of plasma Anti-Müllerian Hormone (P<0.05). No difference was observed concerning adiponectin, resistin and visfatin expression.

Conclusion: Ovarian expression of chemerin, apelin and omentin is higher in PCOS patients compared to controls. Interestingly, the regulation of these adipokines seems to be different in women presenting only polycystic ovarian morphology, who seem to be characterised by a different hormonal profile and better IVF outcomes. Thus, ECHO could be an independent physiopathogenic condition whose metabolic and reproductive profile remains to be clarified.