{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:07:43Z","timestamp":1786626463271,"version":"build-2736575974"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Faculty of Medicine, Ramathibodi hospital, Mahidol University","award":["RF_67042"],"award-info":[{"award-number":["RF_67042"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Polycystic ovarian syndrome (PCOS) is a common endocrine disorder characterized by ovulatory dysfunction. Fertility outcomes in PCOS patients are often suboptimal, potentially owing to alterations in the follicular fluid (FF) microenvironment. However, the differences in FF hormone levels between PCOS and non-PCOS patients, as well as their correlation with assisted reproductive technology (ART) outcomes, remain unclear. This prospective study included 18 PCOS patients and 18 infertile women without PCOS (control group) undergoing intracytoplasmic sperm injection at the Division of Reproductive Medicine, Ramathibodi Hospital. The primary objective was to compare ART outcomes between the groups. Furthermore, FF testosterone, dehydroepiandrosterone sulfate, and luteinizing hormone levels were evaluated to assess their correlation with these outcomes. The number of retrieved oocytes was significantly higher in the PCOS group; however, the rates of metaphase II oocyte formation, fertilization, blastocyst formation, and high-quality blastocyst formation were comparable between the groups. Although FF testosterone and FF luteinizing hormone levels were higher in the PCOS group than in the control group, the differences were not statistically significant. Spearman correlation analysis showed that FF testosterone levels were negatively correlated with fertilization rate (r\u2009= \u22120.3496, p\u2009=\u20090.0366). These findings suggest that increased FF testosterone levels may negatively correlation with fertilization rates, which may reflect one of the contributing factors to the suboptimal ART outcomes observed in PCOS patients.<\/jats:p>","DOI":"10.1371\/journal.pone.0342463","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:23:39Z","timestamp":1770661419000},"page":"e0342463","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Correlation between follicular fluid hormonal levels in PCOS women and embryo development in ART cycles"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5078-387X","authenticated-orcid":true,"given":"Sunatchana","family":"Kongsomnuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pornsri","family":"Niransuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artitaya","family":"Singwongsa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6158-4068","authenticated-orcid":true,"given":"Chonthicha","family":"Satirapod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"issue":"2","key":"pone.0342463.ref001","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.rbmo.2019.03.203","article-title":"A meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF","volume":"39","author":"T Sha","year":"2019","journal-title":"Reprod Biomed Online"},{"issue":"1","key":"pone.0342463.ref002","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1002\/ijgo.13581","article-title":"Thyroid-stimulating hormone level is negatively associated with fertilization rate in patients with polycystic ovary syndrome undergoing in vitro fertilization","volume":"155","author":"H Gao","year":"2021","journal-title":"Int J Gynaecol Obstet"},{"key":"pone.0342463.ref003","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/1741-7015-8-41","article-title":"Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan","volume":"8","author":"H Teede","year":"2010","journal-title":"BMC Med"},{"issue":"2","key":"pone.0342463.ref004","doi-asserted-by":"crossref","DOI":"10.1093\/ejendo\/lvad096","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"189","author":"HJ Teede","year":"2023","journal-title":"Eur J Endocrinol"},{"key":"pone.0342463.ref005","first-page":"104096","article-title":"Follicular fluid PlGF and IVF\/ICSI outcomes among PCOS and normo-ovulatory women using different controlled hyperstimulation protocols: A prospective case-control study","volume":"79","author":"S Kadoura","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"issue":"1","key":"pone.0342463.ref006","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12958-021-00749-6","article-title":"Correlation between steroid levels in follicular fluid and hormone synthesis related substances in its exosomes and embryo quality in patients with polycystic ovary syndrome","volume":"19","author":"L Yu","year":"2021","journal-title":"Reprod Biol Endocrinol"},{"issue":"1","key":"pone.0342463.ref007","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ejogrb.2009.11.017","article-title":"IVF outcome in women with PCOS, PCO and normal ovarian morphology","volume":"149","author":"A Swanton","year":"2010","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"pone.0342463.ref008","doi-asserted-by":"crossref","first-page":"960274","DOI":"10.3389\/fendo.2022.960274","article-title":"Follicular fluid lipidomic profiling reveals potential biomarkers of polycystic ovary syndrome: A pilot study","volume":"13","author":"Y Ding","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"pone.0342463.ref009","first-page":"449","article-title":"Follicular fluid oxidative stress biomarkers and ART outcomes in PCOS women undergoing in vitro fertilization: A cross-sectional study","volume":"19","author":"K Gongadashetti","year":"2021","journal-title":"Int J Reprod Biomed"},{"issue":"1","key":"pone.0342463.ref010","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12958-022-00959-6","article-title":"High androgen concentrations in follicular fluid of polycystic ovary syndrome women","volume":"20","author":"A Bongrani","year":"2022","journal-title":"Reprod Biol Endocrinol"},{"issue":"4","key":"pone.0342463.ref011","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4103\/0974-1208.170397","article-title":"Follicular fluid dehydroepiandrosterone sulfate is a credible marker of oocyte maturity and pregnancy outcome in conventional in vitro fertilization cycles","volume":"8","author":"NM Chimote","year":"2015","journal-title":"J Hum Reprod Sci"},{"issue":"12","key":"pone.0342463.ref012","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1080\/09513590.2019.1622087","article-title":"High concentration of chemerin caused by ovarian hyperandrogenism may lead to poor IVF outcome in polycystic ovary syndrome: a pilot study","volume":"35","author":"Y Wang","year":"2019","journal-title":"Gynecol Endocrinol"},{"issue":"1","key":"pone.0342463.ref013","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.fertnstert.2003.10.004","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome","volume":"81","author":"Rotterdam ESHRE\/ASRM-Sponsored PCOS Consensus Workshop Group","year":"2004","journal-title":"Fertil Steril"},{"issue":"12","key":"pone.0342463.ref014","first-page":"1368","article-title":"The Sixth Edition of the WHO Manual for Human Semen Analysis: A Critical Review and SWOT Analysis","volume":"11","author":"F Boitrelle","year":"2021","journal-title":"Life (Basel)"},{"key":"pone.0342463.ref015","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.rbmo.2017.06.015","article-title":"The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators","volume":"35","author":"ESHRE Special Interest Group of Embryology and Alpha Scientists in Reproductive Medicine","year":"2017","journal-title":"Reprod Biomed Online"},{"issue":"6","key":"pone.0342463.ref016","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1007\/s11154-023-09819-z","article-title":"Follicular fluid composition and reproductive outcomes of women with polycystic ovary syndrome undergoing in vitro fertilization: A systematic review","volume":"24","author":"MV Moreira","year":"2023","journal-title":"Rev Endocr Metab Disord"},{"issue":"5","key":"pone.0342463.ref017","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1210\/er.2015-1104","article-title":"The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited","volume":"37","author":"RL Rosenfield","year":"2016","journal-title":"Endocr Rev"},{"key":"pone.0342463.ref018","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.mce.2017.06.026","article-title":"Role of androgens in the ovary","volume":"465","author":"KA Walters","year":"2018","journal-title":"Mol Cell Endocrinol"},{"issue":"1","key":"pone.0342463.ref019","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/humupd\/dmq032","article-title":"Extra- and intra-ovarian factors in polycystic ovary syndrome: impact on oocyte maturation and embryo developmental competence","volume":"17","author":"J Qiao","year":"2011","journal-title":"Hum Reprod Update"},{"issue":"5","key":"pone.0342463.ref020","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s10815-018-1143-3","article-title":"Influence of follicular fluid and cumulus cells on oocyte quality: clinical implications","volume":"35","author":"MG Da Broi","year":"2018","journal-title":"J Assist Reprod Genet"},{"issue":"3","key":"pone.0342463.ref021","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.tem.2016.11.008","article-title":"Oocyte Competence in Women with Polycystic Ovary Syndrome","volume":"28","author":"S Palomba","year":"2017","journal-title":"Trends Endocrinol Metab"},{"issue":"4","key":"pone.0342463.ref022","first-page":"1158","article-title":"Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries","volume":"79","author":"C Gilling-Smith","year":"1994","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"pone.0342463.ref023","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1210\/en.2019-00101","article-title":"Physiological and Pathological Androgen Actions in the Ovary","volume":"160","author":"O Astapova","year":"2019","journal-title":"Endocrinology"},{"issue":"1","key":"pone.0342463.ref024","doi-asserted-by":"crossref","first-page":"6336","DOI":"10.1038\/s41598-021-85915-x","article-title":"Serum testosterone levels are positively associated with serum anti-mullerian hormone levels in infertile women","volume":"11","author":"L-T Lin","year":"2021","journal-title":"Sci Rep"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T18:23:43Z","timestamp":1770661423000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0342463"}},"subtitle":[],"editor":[{"given":"Akingbolabo Daniel","family":"Ogunlakin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,9]]},"references-count":24,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0342463","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,9]]}}}