{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T14:58:45Z","timestamp":1792421925387,"version":"4.5.0"},"posted":{"date-parts":[[2025,8,12]]},"group-title":"Obstetrics and Gynecology","reference-count":39,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,8,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>\n                  Polycystic ovary syndrome is the most common endocrine condition in women and anovulatory cause of female infertility. While a pro-inflammatory cytokines and leukocyte bias in systemic circulation is well-documented in PCOS, it is not known how this inflammation extends to or affects the ovary. Additionally, the relationship between ovulation and inflammation in PCOS is not well-defined. We hypothesize that the ovarian follicular immune environment in PCOS is uniquely dysregulated, and that resolving anovulation through ovulation induction is not sufficient to alleviate this dysregulation. Using single-cell RNA and surface protein analysis of peripheral blood and follicular fluid from patients undergoing\n                  <jats:italic>in vitro<\/jats:italic>\n                  fertilization, we discovered that both control and PCOS follicles were immunologically distinct from circulation. At a systemic level, we find that ovulation induction in PCOS does not alleviate systemic inflammation. In contrast, while healthy control ovaries experienced acute immune-directed ovulatory signaling, PCOS ovarian follicles were deficient in key pro-ovulatory cell to cell communication, and displayed instead a chronic low-grade inflammatory state with fibrotic features. Taken together, a picture emerges where acute ovulation demonstrates a well-ordered series of follicle-specific immune information flows, which are disrupted and replaced by low grade chronic inflammation in the PCOS follicle.\n                <\/jats:p>","DOI":"10.1101\/2025.08.11.25333027","type":"posted-content","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T15:25:19Z","timestamp":1755012319000},"source":"Crossref","is-referenced-by-count":2,"title":["Single-cell analysis of follicular fluid reveals dysregulation of ovulatory immune function in PCOS patients undergoing ovarian stimulation"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1493-4563","authenticated-orcid":false,"given":"Andrea K.","family":"Wegrzynowicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soma","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Grimes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley","family":"Huddleston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Leyva","family":"Jaimes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura G.","family":"Cooney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar K.","family":"Stanic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2025081420500588000_2025.08.11.25333027v1.1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh098"},{"key":"2025081420500588000_2025.08.11.25333027v1.2","doi-asserted-by":"crossref","first-page":"323","DOI":"10.4049\/immunohorizons.2200033","article-title":"Immune Dysfunction in Polycystic Ovary Syndrome","volume":"7","year":"2023","journal-title":"ImmunoHorizons"},{"key":"2025081420500588000_2025.08.11.25333027v1.3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021688"},{"key":"2025081420500588000_2025.08.11.25333027v1.4","doi-asserted-by":"publisher","DOI":"10.1159\/000081973"},{"key":"2025081420500588000_2025.08.11.25333027v1.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-032110"},{"key":"2025081420500588000_2025.08.11.25333027v1.6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031096"},{"key":"2025081420500588000_2025.08.11.25333027v1.7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2003-031365"},{"key":"2025081420500588000_2025.08.11.25333027v1.8","doi-asserted-by":"crossref","first-page":"103083","DOI":"10.1016\/j.jri.2020.103083","article-title":"IL-18 and IL-18 binding protein concentration in ovarian follicular fluid of women with unexplained infertility to PCOS during in vitro fertilization","volume":"138","year":"2020","journal-title":"J Reprod Immunol"},{"key":"2025081420500588000_2025.08.11.25333027v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2015.12.003"},{"key":"2025081420500588000_2025.08.11.25333027v1.10","doi-asserted-by":"crossref","first-page":"3459","DOI":"10.1210\/jc.2015-4275","article-title":"Enhanced Inflammatory Transcriptome in the Granulosa Cells of Women With Polycystic Ovarian Syndrome","volume":"101","year":"2016","journal-title":"J. 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