Aberrant Expression of the Epidermal Growth Factor Family in Women With Different Polycystic Ovary Syndrome Subtypes: An Observational Case-Control Study

Background:Alterations in epidermal growth factor (EGF) family members in patients with polycystic ovary syndrome (PCOS), a highly heterogeneous condition, remain controversial. This case-control study investigated EGF family levels in PCOS subtypes and analyzed their correlation with in vitro fertilization (IVF) pregnancy outcomes.Methods: Follicular fluid samples were collected from 94 women with PCOS and 81 control women who underwent IVF embryo transfer and serum samples were obtained from a subset of the same cohort, including 58 women with PCOS and 32 controls. EGF and amphiregulin (AREG) levels were evaluated. EGF and AREG levels in the serum and follicular fluid of patients with PCOS were analyzed by subtype. The correlation between follicular fluid AREG levels and IVF pregnancy rates in PCOS, particularly in subtype A (anovulation [AO] + hyperandrogenism [HA] + polycystic ovaries [PCO]), was investigated. EGF receptor (EGFR) gene expression was measured by real-time PCR.Results:Serum EGF levels were significantly elevated, whereas serum AREG levels were lower in patients with PCOS. Changes in serum EGF and AREG levels across PCOS subtypes were consistent with the overall disease phenotype. Follicular fluid AREG levels were significantly lower in PCOS subtype A compared with controls. Pregnancy rates showed a decreasing trend in the PCOS subtype A group, potentially related to the decreased follicular fluid AREG levels in these patients, although validation requires a larger sample size. Real-time PCR analysis revealed higher expression of the EGFR gene in the ovarian follicular granulosa cells from women with PCOS than in controls.Conclusions:This study found altered expression of EGF, the EGF family member AREG, and the EGFR gene in patients with PCOS.