CYP19 gene variants affect the assisted reproduction outcome of women with polycystic ovary syndrome

Objective: Cytochrome P450 aromatase catalyzes the irreversible transformation of androgens into estrogens. The association of CYP19(TTTA)(n) polymorphism with the hormonal profile and the assisted reproduction outcome of women with polycystic ovary syndrome (PCOS) was explored. Methods: One hundred and thirty-two women with PCOS and 200 with male-factor infertility, as controls, participated in the current study. The CYP19(TTTA)(n) polymorphism was genotyped, while the hormonal profile was determined at the third day of the menstrual cycle. During oocyte retrieval, the follicular size, the follicle and oocyte numbers were recorded. Results: Genotype analysis revealed 6 CYP19(TTTA)(n) alleles with 7-12 repeats. In PCOS women, the CYP19(TTTA)(7) allele presence was associated with lower serum E-2 levels at the third day of the menstrual cycle (p<0.009), lower large follicle (p<0.02) and total oocyte numbers (p = 0.006), but with significantly higher pregnancy rates after assisted reproduction (p<0.004). Conclusions: Potential associations of the CYP19(TTTA)(7) allele with ovarian response to standard gonadotrophin stimulation and with assisted reproduction outcome were found in PCOS women, probably due to androgen/estrogen ratio alterations.