Various studies have examined the quality of oocytes and embryos in PCOS. One study reported that patients with PCOS were associated with decreased fertilization rates[33]. The intra-cytoplasmic sperm injection of oocytes from females with PCOS resulted in delayed embryonic development and hyperandrogenism[34].
Additionally, granulosa cells and cumulus cells are reported to affect oocyte quality and oocyte maturation in patients with PCOS[8, 35]. Meanwhile, the interaction between granulosa, cumulus cells, and oocytes is critical for oocyte maturation[36, 37]. This indicated that oocytes are also important for follicle development. However, limited studies have performed the genetic analysis of oocytes in PCOS. This may be due to the difficulty associated with the accessibility of human oocytes.
Several types of androgens, including DHT and dehydroepiandrosterone, have been used to model PCOS in mice[24]. Prenatal treatment with DHT resulted in irregular estrous cycles, PCO-like ovarian morphology, and increased levels of serum luteinizing hormone (LH) without marked effects on bodyweight. This model mimics the PCOS phenotype, which is characterized by physiological bodyweight and enhanced LH secretion. In this study, the oocytes of the PCOS model exhibited a PCO-like ovarian morphology and ovulatory dysfunction but not high testosterone levels at the time of oocyte retrieval.
RNA-Seq revealed that compared with those in the oocytes of the control group, the Igfbp5 expression levels were upregulated and the Hspa1a and Zscan4b expression levels were downregulated in the oocytes of the PCOS mouse model. The expression levels of IGFBP5 in the cumulus cells of immature follicles were significantly higher than those in the cumulus cells of mature follicles in patients with PCOS. The upregulated levels of IGFBP5 are reported to inhibit oocyte maturation in patients with PCOS[38]. A previous study reported that HSPA1A is involved in embryonic maturation and that the expression of HSPA1A was downregulated in the granulosa cells of patients with PCOS[39]. The downregulation of Hspa1a in the oocytes of the PCOS mouse model may impair its function in embryonic maturation. ZSCAN4B, a Zscan4 paralog, is reported to be involved in DNA-binding transcription factor activity and embryo implantation[40]. These findings demonstrated that the DEGs of oocytes in the PCOS mouse model are associated with the disorders of oocyte or embryo maturation and implantation in PCOS.
GO and KEGG pathway enrichment analyses revealed that the ribosomal pathway was upregulated in the oocytes of the PCOS mouse model. Five upregulated DEGs (Rps21, Rpl36, Rpl36a, Rpl37a, and Rpl22l1) were enriched in the ribosomal pathways. In particular, immunohistochemical analysis revealed that the expression levels of Rps21 and Rpl36 in the oocytes of the PCOS group were higher than those in the oocytes of the control group. The expression levels of Rps21 and Rpl36 in the oocytes based on the follicle stage were examined using immunohistochemical analysis. The Rps21 and Rpl36 levels were upregulated in the preantral follicles of both control and PCOS groups but downregulated in the oocytes of the small and large antral follicles (later stages of follicle development). Additionally, the Rps21 and Rpl36 levels in the oocytes in the small antral follicles of the PCOS group were higher than those in the oocytes in the small antral follicles of the control group. The main role of ribosomes is to translate mRNAs into proteins in the nucleolus[41]. The number of ribosomes increases with age, which may affect the accuracy and efficiency of ribosome translation and consequently result in the production of poor-quality proteins and oocytes[42]. The deletion of Rps26, a ribosomal protein component, in oocytes inhibited oocyte growth and impaired follicle development by downregulating the protein levels of oocyte-derived Gdf9, Bmp15, and Gj4 (an oocyte-granulosa cell gap junction protein)[43]. Additionally, in the fertilization process, the ribosomal pathway is associated with poly-pronuclear (PN) and poly-PN arrest zygotes, which exhibit defects in the meiosis process and oocyte maturation, and is repressed in the early stage of oocytes in patients with PCOS[44]. These findings suggest that the upregulation of the ribosomal pathway in PCOS is involved in oocyte development and maturation during follicle development. The upregulation of the ribosomal pathways promotes translation and oocyte growth. However, the aberrant overexpression of the ribosomal pathway could inhibit the oocyte maturation process and impair embryonic development. In this study, small antral follicles in the PCOS group exhibited upregulated protein levels of Rps21 and Rpl36, which suggested that the altered expression of these ribosomal proteins in follicles at this stage is associated with the disorders of subsequent follicle maturation.
This study has some limitations. The findings of this animal study have not been validated in human samples. Additionally, the mechanism underlying the androgen-induced alteration in gene expression during fetal development was not elucidated in this study. DNA methylation, an epigenetic modification, regulates the identity of a cell without changing the DNA sequence[45]. During the gestation period, the environment promotes changes in DNA methylation[46–48]. Therefore, DMRs were analyzed in this study. However, the methylation alterations determined in this study were not associated with changes in gene expression. Finally, the small number of oocytes used for DNA methylation analysis may skew the results.
In summary, this study performed a genome-wide analysis of oocytes from the PCOS mouse models. The findings of this study indicate that the upregulated ribosomal pathway may impair oocyte maturation in PCOS.
These findings are expected to improve our understanding of the mechanism of follicle development disorders and contribute to favorable fertility outcomes in patients with PCOS. Future studies must focus on the altered gene expression of oocytes in patients with PCOS and determine the functions of these genes in PCOS phenotype using animal models and human samples.