Intrafollicular levels of matrix metalloproteinases-2 and -9 in patients with polycystic ovaries are not associated with pregnancy rate during IVF cycle.

This study aimed to detect the levels of matrix metalloproteinases (MMP)-2 and -9, using enzyme-linked immunosorbent assays, in the follicular fluid of 35 patients with polycystic ovaries, compare them with the levels found in 35 normally ovulating women enrolled in their first in vitro fertilization (IVF) cycle and then correlate them with pregnancy rates in these two groups. Levels of MMP-9 were found significantly increased in women with polycystic ovaries when compared with the controls, while MMP-2 levels were higher in women with polycystic ovaries without reaching statistical significance. The two groups did not differ in age, in the number of embryos transferred or in pregnancy rates. In conclusion, the results indicated an increased gelatinolytic activity in patients with polycystic ovaries after ovarian stimulation for IVF treatment without detecting any association between levels of MMP-2 and 9 and IVF pregnancy rates. The initiation of pregnancy in an IVF cycle is dependent on a plethora of factors such as follicular development, number of retrieved oocytes, fertilization, embryo development and finally, implantation. All these processes require continuous changes, first in the ovaries and then in the uterus. Human ovaries are subjected throughout the entire reproductive life to extensive tissue remodeling secondary to functional changes during follicular growth, ovulation and atresia. The profound remodeling of extracellular matrix, comprising degradation and recomposition, is determined greatly by the activity of metalloproteinases (MMPs), a group of proteolytic enzymes (gelatinases). Thus, the presence of MMPs in the follicular microenvironment is important for the subsequent follicular development. Decreased levels of MMPs in preovulatory follicular fluid (FF) have been associated with deficient follicular growth and/or ovulation (1).