Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in women. Folliculogenesis in the PCOS ovary is often disrupted, leading to suboptimal oocyte competence for fertilization. This alteration in oocyte development is likely due to intrinsic molecular defects in the oocyte along with the state of androgen excess in PCOS patients. Many therapeutic options are available to infertile couples with PCOS, including controlled ovarian hyperstimulation and in vitro fertilization. However, because of immature oocytes, many patients are not able to conceive using standard infertility treatments. The advent of in vitro maturation may allow patients an alternative option by which to achieve conception. This review is intended to describe the mechanisms of aberrant folliculogenesis and their impact on fertility in the PCOS patient.
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