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Declines in anti-Müllerian hormone faster, ovarian volume slower in PCOS
Compared with healthy controls, women with polycystic ovary syndrome demonstrated a slower decline in ovarian volume with aging and a faster decline in anti-Müllerian hormone, study data showed.
“Women with PCOS have ovaries with increased ovarian stroma, an increased number of follicles and a thicker, hyperplastic theca-cell layer compared with women without PCOS,” Asima K. Ahmad, MD, MPH, a clinical fellow at the Center for Reproductive Health at the University California San Francisco School of Medicine, and colleagues wrote. “Whether these variations in ovarian features are also associated with differences in ovarian aging is not known. An understanding of possible differences in ovarian aging in PCOS and normal populations could shed light on determinants of this critical aspect of reproductive physiology.”
Ahmad and colleagues performed a longitudinal study of 32 women with PCOS aged 18 to 50 years and compared them with healthy controls from the Ovarian Aging study, a longitudinal study of women with regular menstrual cycles. The main outcomes were measures of ovarian volume, anti-Müllerian hormone concentration and antral follicle count collected over the course of two visits. The mean length of follow-up was 3.21 years in controls and 3.9 years in participants with PCOS.
The women with PCOS had higher baseline levels of all markers compared with controls.
Ahmad and colleagues wrote that women with PCOS showed faster declines in antral follicular count (difference, –2.09 follicles; 95% CI, –3.21 to –0.97) and anti-Müllerian hormone (difference, –2.67; 95% CI, –3.48 to –1.85) compared with controls. There were no significant differences between groups in changes in ovarian volume, however.
After adjusting for age, BMI and baseline ovarian markers, the researchers reported that women with PCOS did not have a faster decline in antral follicular count, but did experience faster declines in anti-Müllerian hormone and slower declines in ovarian volume (both P < .01).
“An important strength of this study is that it represents the largest longitudinal study to compare rates of ovarian aging between PCOS and community control subjects,” the researchers wrote. “The results provide insight into the biology of reproductive aging by suggesting that rates of loss are higher in PCOS but that this rate of loss is strongly influences by baseline values.” – by Andy Polhamus
Disclosures: The authors report no relevant financial disclosures.