The Effect of Normal Follicular Fluid on the Differentiation of PCOS Ovarian Stem Cells into Oocyte-Like Cells

Background: Polycystic ovarian syndrome (PCOS) is one of the causes of infertility for which treatment methods do not have a high rate of pregnancy. In this study, the stem cells in the follicular fluid (FF) of patients were grown in the normal FF, and their differentiation into oocytes was evaluated. Materials and Methods: The FF of PCOS patients was centrifuged, and their cells were cultured with and without 20% normal FF for 2 weeks. The cells were evaluated for their morphology by inverted microscope and for markers of stem cells (NANOG and OCT4) and oocytes (zona pellucida (ZP) 2 and ZP3) by RT-PCR and immunocytochemistry. The amount of steroids was measured by enzyme-linked immunosorbent assay (ELISA). Results: The cells were all round on day 0. After that, they had a heterogeneous morphology (fibroblast-like cells, epithelial-like cells, and round oocyte-like cells). In the first week, NANOG and OCT4 genes in the study group were less expressed than those in the control group (P < 0.0001) (~0.5-fold), while ZP2 and Z3 genes were more expressed (P < 0.0001) (~2-fold). In the second week, stem cell genes were more expressed in the control group (~2 fold), and oocyte genes were more expressed in the study group (P < 0.0001) (~2.5–3.11 fold). These results were also confirmed by immunocytochemistry. The amount of steroids was much higher in the study group (three times and five times in two weeks) (P < 0.0001). Conclusions: Stem cells can be obtained from the FF of PCOS, and normal FF has a positive effect on the growth and maturation of oocyte-like cells in vitro