title: The effect of estradiol on granulosa cell responses to FSH in women with polycystic ovary syndrome.
abstract: BACKGROUND
  The influence of estradiol (E2) on granulosa cell (GC) function has not been tested clinically in women with polycystic ovary syndrome (PCOS). The objective of this study is to determine if E2influences GC responses to FSH in women with PCOS.
  
  
  METHODS
  This is a two phase, single cohort study conducted over a 2-year period at a single academic center. Nine women with PCOS according to NIH criteria. In Phase 1, FSH stimulation of GC responses as measured by E2and Inhibin B (Inh B) were assessed before and at 5 and 6 weeks after GnRH agonist administration. In Phase 2, the same protocol was employed with the addition of an aromatase inhibitor (letrozole, LET) administered daily beginning at week 4 for 2 weeks.
  
  
  RESULTS
  In Phase 1, recovery of FSH, E2and Inh B from ovarian suppression occurred at 5 and 6 weeks after GnRH agonist injection and preceded resumption of LH and androgen secretion. In Phase 2, hormone recovery after GnRH agonist was characterized by elevated FSH and suppressed E2levels whereas recovery of LH and androgen levels were unchanged. In Phase 1, FSH stimulated E2and Inh B responses were unaltered during recovery from ovarian suppression. In Phase 2, E2and Inh B fold changes after FSH were significantly reduced at weeks 5 (p < 0.04) and 6 (p < 0.01), respectively.
  
  
  CONCLUSIONS
  In anovulatory women with PCOS, chronic, unopposed E2secretion may contribute, at least in part, to enhanced ovarian responsiveness to FSH.
  
  
  BACKGROUND
  NCT02389088.
authors.affiliation: Reproductive Medicine, University of California, 200 West Arbor Drive MC: 8710, San Diego, CA, 92103, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Homer
authors.affiliation: Reproductive Endocrinology and Infertility, Southern California Permanente Medical Group, 6650 Alton Parkway, Irvine, CA, 92618, USA.
authors.forename: Marcus A
authors.initials: MA
authors.lastname: Rosencrantz
authors.affiliation: Obstetrics and Gynecology, Southern California Permanente Medical Group, 250 Travelodge Drive, El Cajon, CA, 92020, USA.
authors.forename: Rana F
authors.initials: RF
authors.lastname: Shayya
authors.affiliation: Reproductive Medicine, University of California, 200 West Arbor Drive MC: 8710, San Diego, CA, 92103, USA. rjchang@ucsd.edu.|, 9500 Gilman Drive #0633 La Jolla, San Diego, CA, 92093, USA. rjchang@ucsd.edu.
authors.forename: R Jeffrey
authors.initials: RJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D047072:Aromatase Inhibitors / Q000008:administration & dosage; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D006107:Granulosa Cells / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007265:Inhibins / Q000097:blood; D000077289:Letrozole; D009570:Nitriles / Q000008:administration & dosage; D011085:Polycystic Ovary Syndrome / Q000097:blood*; D013997:Time Factors; D014230:Triazoles / Q000008:administration & dosage
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D000077289:Letrozole; D005640:Follicle Stimulating Hormone
keywords: Estradiol; FSH; Granulosa cell; Inhibin B; Polycystic ovary syndrome