Early follicular development in polycystic ovaries (PCO) is abnormal; a higher proportion of follicles have entered the growing phase than in normal ovaries . IGF-I stimulates the initiation of preantral follicle growth in a human tissue culture system using a growth factor-reduced extracellular matrix, Matrigel . The aim of this study was to compare the effects of IGF-I on early preantral follicle development in polycystic and normal ovaries. Small ovarian cortical biopsies were obtained at laparoscopy, with informed consent and local ethical committee approval, from 29 women (12-PCO, 17-normal ovaries). The tissue was cut into pieces less than 1millimetre3. One piece was immediately fixed (day 0 control), and the remainder were randomly allocated to 4 culture conditions: alpha MEM with 10 per cent HSA supplemented with 0,1,10,100 nanograms per millilitre IGF-I. The tissue was cultured for 7 days on a growth factor-reduced Matrigel coated insert. After culture, the tissue was fixed, serially sectioned and stained with haematoxylin and eosin. In the day 0 control sample, we observed the expected increase in the proportion of growing follicles in PCO compared with normal ovaries  and this difference was maintained after 7 days in culture, in the absence of IGF-1 (p=0.057). The addition of IGF-I at 1 nanogram per millilitre to the culture media increased the proportion of growing follicles in normal ovaries (p=0.004), and further increased the proportion of growing follicles in PCO (p=0.047). Higher doses of IGF-1 had no additional effect in either normal or PCO. In summary, these results confirm the utility of our tissue culture system, using growth factor-reduced Matrigel, for the study of follicular dynamics in both PCO and normal ovaries. IGF-I (or IGF-2) is a possible candidate for increasing initiation of follicle growth in PCO. This work is supported by MRC and Wellbeing
 Webber et al, Lancet 2003 362 1017-21  Stubbs et al, Endocrine Abstracts 2003 6 OC7.
22 - 24 Mar 2004
British Endocrine Societies