Surface ultrastructure of polycystic ovaries as viewed by electron microscopy.

Scanning electron microscopy was used to observe surface fine structure of germinal epithelium and granulosa cells of human ovaries from 24 patients with polycystic ovaries and primary infertility. Synthetic LH-RH was administered intravenously and serum LH was measured at frequent intervals before and after LH-RH injection. The PCO patients were arbitrarily classified into two groups on the basis of ovarian morphology: typical PCO (Type I) with greater LH response than the lower LH response of a typical PCO (Type II). The germinal epithelium which did not completely cover the surface of the normal ovary was characterized by patchy areas of cells with and without dense microvilli. In normal preovulatory follicles, most granulosa cells were polyhedral in shape with smooth surfaces, whereas those facing the follicular cavity were elongated and flattened and were covered with material having a filamentous/reticular texture. In PCO the germinal epithelium surrounding the whole surface possessed dense microvilli, solitary cilia, and blebs, resembling the fetal ovary. In normal ovaries, the follicular cells were uniform in size and shape with microvilli and evaginations. The PCO cells have irregular size and shape with few microvilli.