Prorenin is elevated in polycystic ovary syndrome and may reflect hyperandrogenism.
OBJECTIVE
To examine the null hypothesis that women with polycystic ovary syndrome (PCOS) produce similar levels of prorenin and other components of the ovarian-derived prorenin to angiotensin cascade (ODPAC) at baseline and after stimulation with clomiphene citrate (CC) or hMG when compared with normal age- and weight-matched ovulatory controls.


METHODS
Prospective controlled clinical trial.


METHODS
Infertility clinic in a university-based county hospital and a hospital-based private infertility practice.


METHODS
Twenty-eight infertile women aged 18 to 35 years. Thirteen patients were diagnosed with PCOS. Fifteen normal ovulatory patients who were matched for age and weight served as controls.


METHODS
Twenty patients were stimulated with CC and eight were stimulated with hMG.


METHODS
Serum E2, P, T, androstenedione (A), DHEAS, LH, FSH, and plasma prorenin, active renin, and angiotensin II (Ang II) were measured at baseline and during the preovulatory and midluteal phases of the stimulation cycles.


RESULTS
Baseline plasma prorenin in PCOS was higher than that of follicular phase controls. Plasma prorenin correlated significantly with peripheral androgen levels. Prorenin, active renin, and Ang II increased in response to gonadotropins with the largest increases occurring in control patients receiving CC. An association was seen between ovulation with CC and lower baseline levels of active renin.


CONCLUSIONS
The null hypothesis was rejected. Infertile women with PCOS have higher baseline prorenin levels when compared with age- and weight-matched ovulatory controls. There is a significant correlation between prorenin and the peripheral levels of androgens produced during ovarian stimulation. Baseline active renin levels may be predictive of ovulation with CC.
Morris
R S
RS
Division of Reproductive Endocrinology, University of Southern California School of Medicine, Los Angeles, USA.
Wong
I L
IL
Hatch
I E
IE
Gentschein
E
E
Paulson
R J
RJ
Lobo
R A
RA
D000293:Adolescent; D000328:Adult; D000735:Androstenedione / Q000097:blood; D000804:Angiotensin II / Q000097:blood; D002996:Clomiphene; D003687:Dehydroepiandrosterone / Q000031:analogs & derivatives / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate; D004792:Enzyme Precursors / Q000097:blood*; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood*; D007247:Infertility, Female / Q000097:blood; D016555:Matched-Pair Analysis; D008596:Menotropins; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D011446:Prospective Studies; D012083:Renin / Q000097:blood*; D013739:Testosterone / Q000097:blood
D004792:Enzyme Precursors; D000804:Angiotensin II; D002996:Clomiphene; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate; D008596:Menotropins; D012083:Renin