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


METHODS
Cross-sectional study.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Bili
H
H
Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Laven
J
J
Imani
B
B
Eijkemans
M J
MJ
Fauser
B C
BC
D000293:Adolescent; D000328:Adult; D000375:Aging; D000568:Amenorrhea / Q000150:complications; D000735:Androstenedione / Q000097:blood; D001824:Body Constitution; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D005215:Fasting; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006065:Gonadotropins, Pituitary / Q000097:blood*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D007265:Inhibins / Q000097:blood; D007328:Insulin / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D009839:Oligomenorrhea / Q000150:complications; D006080:Ovarian Follicle / Q000000981:diagnostic imaging; D010053:Ovary / Q000000981:diagnostic imaging; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography
D006065:Gonadotropins, Pituitary; D007328:Insulin; C422364:inhibin B; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone