title: Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years.
abstract: 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.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Bili
authors.forename: J
authors.initials: J
authors.lastname: Laven
authors.forename: B
authors.initials: B
authors.lastname: Imani
authors.forename: M J
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: B C
authors.initials: BC
authors.lastname: Fauser
mesh_terms: 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
chemical_list: D006065:Gonadotropins, Pituitary; D007328:Insulin; C422364:inhibin B; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone