Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhea infertile women of reproductive years

Department of Obstetrics and Gynaecology, Erasmus University Rotterdam, Rotterdam, South Holland, Netherlands
European Journal of Endocrinology (Impact Factor: 4.07). 01/2002; 145(6):749-55. DOI: 10.1530/eje.0.1450749
Source: PubMed


To assess the effect of age on clinical, endocrine and sonographic features associated with polycystic ovary syndrome (PCOS) in normogonadotrophic anovulatory infertile women of reproductive years.
Cross-sectional study.
Four hundred and seventy-two oligo-amenorrhoeic infertile patients, presenting with normal FSH and oestradiol concentrations, aged 17-42 years underwent a standardised initial evaluation including: cycle history, body mass index, waist-to-hip ratio and transvaginal ultrasound scanning of ovaries. Fasting blood samples were obtained for extensive endocrine evaluation. Cycle duration, serum levels of gonadotrophins, androgens, oestradiol, insulin, glucose, inhibin B as well as mean number of follicles, ovarian volume and ovarian stroma echogenicity were assessed.
Older women had significantly lower LH and androgen and inhibin B serum levels. Similarly, older women presented with a reduced number of ovarian follicles. Age was inversely correlated with cycle duration (r=-0.112, P=0.02), LH (r=-0.154, P=0.001), testosterone (r=-0.194, P=0.001), androstenedione (r=-0.170, P=0.001), dehydroepiandrosterone (r=-0.157, P=0.001), insulin (r=-0.126, P=0.02), inhibin B (r=-0.118, P=0.03) serum levels and mean follicle number (r=-0.100, P=0.03). A positive correlation was observed between age and glucose to insulin ratio (r=0.138, P=0.009).
Advanced age in normogonadotrophic anovulatory infertile women is associated with lower LH and androgen levels and with a decreased number of ovarian follicles. Although during reproductive years observed differences are relatively small, these age-related changes may affect the observed incidence of PCOS.

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Available from: Bart C J M Fauser
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    • "Furthermore, aging may also be associated with a defect in insulin action (Rowe et al., 1983). Therefore, the clinical features and metabolic consequences of PCOS may change with age (Rodríguez-Morán and Guerrero-Romero, 2003), and these age-related changes may affect the observed incidence of PCOS (Bili et al., 2001). Unfortunately, there have been few reports examining the differences in the phenotype and clinical presentation of PCOS based on age (Pasquali and Grambineri, 2006a). "
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    • "Inhibin B is a marker of ovarian antral follicle cohort in PCOS (Bili et al., 2001) and eumenorrheic women (Danforth et al., 1998). Bili et al. (2001) found an age-related reduction in the number of antral follicles and a decrease in inhibin B in 472 PCOS patients and Elting, in 27 women found an age-related reduction in inhibin B increment during FSH-stimulated ovarian reserve testing (Elting et al., 2001). However, Piltonen et al. (2004) found unchanged age-related inhibin B levels in 42 women with PCOS. "
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    • "Earlier studies have shown that the prevalence of PCO decreases with age (Koivunen et al., 1999; Bili et al., 2001). Furthermore, the women with PCOS have been shown to gain regular menstrual cycles when ageing, probably due to age-related follicle loss in the ovaries (Elting et al., 2000). "
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