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Submitted on March 30, 2005
Accepted on July 11, 2005
Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114; Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA 02115 and Department of Pathology and Laboratory Medicine, Women and Infants Hospital, Providence, RI 02903
* To whom correspondence should be addressed. E-mail: cwelt{at}partners.org.
Context: Previous studies suggest that inhibin subunit expression is decreased in granulosa cells of women with polycystic ovary syndrome (PCOS).
Objective: To test the hypothesis that inhibin A and inhibin B protein concentrations are also decreased in PCOS follicles, follicular fluid inhibin concentrations were examined.
Design: Parallel study
Setting: In vitro fertilization suite
Participants: Women with regular cycles (n = 36) and PCOS (n = 8)
Interventions: Follicular fluid was aspirated from the follicles of women with PCOS (n = 14 follicles) and with regular cycles at various times during the follicular phase (n = 50 follicles).
Main Outcome Measure
Inhibin A and B concentrations from PCOS follicles were compared with those in size-matched follicles, dominant follicles (
10 mm) and subordinate follicles from regularly cycling women.
Results: Inhibin A (220 ± 38 vs. 400 ± 72 IU/mL; P < 0.05) and inhibin B (75.4 ± 10.4 vs. 139 ± 26 ng/mL; P < 0.05) concentrations were lower in the follicular fluid of PCOS follicles compared with size-matched follicles from regularly cycling women. Inhibin A was also lower in the follicular fluid of PCOS compared with subordinate follicles from normal women (577 ± 166 IU/mL; P < 0.05). Inhibin A concentrations increased with increasing follicle size, resulting in significantly higher follicular fluid concentrations in dominant follicles from normal women compared with PCOS follicles (2298 ± 228 IU/mL; P < 0.05).
Conclusions: These data demonstrate that inhibin A and inhibin B concentrations are significantly reduced in the follicular fluid of women with PCOS compared with size-matched follicles from normal women, consistent with the decreased inhibin subunit mRNA expression in previous studies. These findings point to the potential importance of the inhibins in normal follicle development and suggest that inhibin deficiency may play a role in the follicle arrest associated with PCOS.
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