Follicular development and endometrial receptivity of different androgen phenotypes in polycystic ovary syndrome

Abstract

Abstract Objective The study was conducted to explore the follicular development and endometrial receptivity of different androgen phenotypes in reproductive-aged patients with PCOS. Methods Two hundred and sixty-eight polycystic ovary syndrome (PCOS) patients with infertility were recruited and divided into two groups according to different androgen phenotypes in this study: abnormal menstruation and hyperandrogenism (AM-HA group, n = 127), abnormal menstruation and polycystic ovarian morphology (AM-PCOM group, n = 141). The follicular development, endometrial receptivity and pregnancy rates of natural cycle between the two groups were compared. Results The number of dominant follicle, number of ovulation, and normal ovulation rate in AM-HA group were significantly lower compared with AM-PCOM group (P < 0.05). The endometrial thickness (ET), endometrial volume (EV), vascularization index (VI), flow index (FI) and vascularization flow index (VFI) on days from 14 to 24 of the menstrual cycle were significantly lower in AM-HA group than in AM-PCOM group (P < 0.05). The endometrial VI, FI and VFI, the integrin αvβ3 and VEGF concentrations in uterine fluid during implantation window were significantly lower in AM-HA group compared with AM-PCOM group (P < 0.05). However, no statistically significant differences were observed in uterine artery blood flow parameters, ET and EV between the two groups (P > 0.05). The biochemical pregnancy rate, clinical pregnancy rate and ongoing pregnancy rate in AM-HA group were significantly lower than in AM-PCOM group (P < 0.05). Conclusion The phenotype of AM-HA in PCOS patients was vulnerable to ovulation disorder and impaired endometrial receptivity, which resulted in reduced pregnancy rate. Treatment of HA is likely to become an effective approach for improving endometrial receptivity and fecundity disorders in patients with PCOS.