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Background  In an article published in 2017 ,  we discussed the results of the first part of our study into the morphokinetic development of embryos in relation to follicle diameter and homogeneity of follicular development. Our findings showed that embryos coming from small follicles in heterogeneous cycles had significantly higher rates of arrest or failure to reach blastocyst than embryos coming from large follicles in homogenous cycles. The aim of this further study was to investigate the relationship between follicular size and gene expression of cumulus cells (CCs) and evaluate whether gene expression could be an indicator of embryo development.    Methods  This study was based on 2495 COCs from 184 patients. CC expressions of five genes ( TNFAIP6 ,  PTGS2 ,  HAS2 ,  PTX3  and  GDF9 ) were studied by generalized linear mixed models (GLMMs) regarding follicular size. CC expressions were then separately analysed regarding patient-specific variables (age, BMI, AMH and follicular size) in relation to embryos reaching blastocyst (eRB) or top or good quality blastocysts (TQ + GQ) using GLMMs with logit link.    Results  Follicular size significantly correlated with the potential of an oocyte to develop into a blastocyst: oocytes developing from large follicles were more than twice as likely to develop into an eRB than oocytes from small follicles ( p  < 0.001). Gene expression of  HAS2  and  GDF9  correlated with blastocyst quality when separately evaluated with follicular size and the patient specific variables of age, BMI and AMH. However, no such correlation was found in other gene expressions studied.    Conclusions  Our findings suggest that differences in the expression of genes studied could be related to follicular size rather than to embryo quality. Although gene expression of  HAS2  and  GDF9  correlated with blastocyst quality, the only variable correlating with eRB and TQ and GQ blastocysts for each of these five models was follicular size.    Trial registration  This prospective cohort study was registered at clinicaltrials.gov (NCT02230449).    Electronic supplementary material  The online version of this article (10.1186/s12958-018-0388-0) contains supplementary material, which is available to authorized users.

Is there a correlation between follicle size and gene expression in cumulus cells and is gene expression an indicator of embryo development?