title: A prospective evaluation of antral follicle function in women with 46,XX spontaneous primary ovarian insufficiency.
abstract: OBJECTIVE
  To assess ovarian follicle function in women with 46,XX spontaneous primary ovarian insufficiency.
  
  
  METHODS
  Case-control with nested prospective cohort.
  
  
  METHODS
  Clinical Research Center, National Institutes of Health.
  
  
  METHODS
  Women with primary ovarian insufficiency without estrogen replacement for 2 weeks (N = 97) and regularly menstruating control women (N = 42).
  
  
  METHODS
  Single injection of 300 IU hrFSH.
  
  
  METHODS
  Change in serum estradiol at 24 hours.
  
  
  RESULTS
  Antral follicles ≥3 mm were detected in 73% (69/95) of patients; both serum estradiol and progesterone levels correlated significantly with maximum follicle diameter in these women. Patients with a maximum follicle diameter ≥8 mm had significantly higher serum estradiol and progesterone levels and significantly lower FSH and LH levels compared with patients without such follicles. In controls estradiol levels increased significantly after FSH administration, but in patients this was not the case despite the presence of an antral follicle ≥8 mm.
  
  
  CONCLUSIONS
  Most women with 46,XX spontaneous primary ovarian insufficiency have antral follicles detectable by ultrasound, suggesting that down-regulation of FSH receptors is not the predominant mechanism of follicle dysfunction. Evidence of progesterone secretion by antral follicles ≥8 mm in these patients is consistent with prior histologic evidence that follicle luteinization is the predominant mechanism of follicle dysfunction in this condition. Prospective controlled investigation designed to improve ovulatory function and fertility in these women is indicated.
authors: Integrative Reproductive Medicine Unit, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
authors: Ziad R
authors: ZR
authors: Hubayter
authors: Vaishali
authors: V
authors: Popat
authors: Vien H
authors: VH
authors: Vanderhoof
authors: Obioma
authors: O
authors: Ndubizu
authors: Diane
authors: D
authors: Johnson
authors: Edie
authors: E
authors: Mao
authors: Karim A
authors: KA
authors: Calis
authors: James F
authors: JF
authors: Troendle
authors: Lawrence M
authors: LM
authors: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000494:pharmacology; D040181:Genetic Diseases, X-Linked / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010049:Ovarian Diseases / Q000378:metabolism / Q000503:physiopathology*; D006080:Ovarian Follicle / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D011962:Receptors, FSH / Q000378:metabolism; D055815:Young Adult
chemical_list: D011962:Receptors, FSH; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone