| Objective 1. To analyze the change of inhibin B (INHB) level in the serum of women withpolycystic ovary syndrome (PCOS), and to explore the role of INHB in thepathophysiological changes of PCOS; 2. To explore the value of serum INHB in predictingovarian reserve in clomiphene citrate(CC)-induced ovulation in women with PCOS.Methods Basal serum INHB, FSH, LH, E2, etc. levels were detected by enzyme-linkedimmunosorbent assay (ELISA) technique both in PCOS group with 31 women and incontrol group with 22 women, and the correlation between two groups and with other sexhormones were analyzed, on days 5～9 of cycle 100mg/d of CC were taken orally by thosewomen. 31 women with PCOS were allocated into two groups with diagnosis criteria:good ovarian reserve group (group A) with basal FSH≤10U/L, and/or d10FSH≤20U/L;basal E2＜60pg/ml, d10E2 rise significantly, 2 times or even higher more than basal E2;mature follicles can be seen under ultrasound. And poor ovarian reserve group (group B) isthose who don't fit the criteria before. Serum INHB, FSH, LH, E2 levels were analyzed.Receiver operating characteristic (ROC) analysis was then used for all possible prognosticvariables to evaluate the value of different hormone in predicting ovarian reserve. Thesensitivity and specificity were calculated at the discriminating cut-off point.Results 1. There was no significant difference between the women with PCOS and thecontrols in age and BMI (P＞0.05), while there was significant difference in WHR (P＜0.01). 2. Basal serum concentrations of FSH were lower than the controls (5.30±2.06 vs.6.36±1.48U/L, t=-2.061, P＜0.05); LH were higher than those of the controls (14.93±6.53 vs. 4.16±1.30U/L; t=8.929, P＜0.01); E2 were higher than those of controls (58.17±13.29 vs. 47.21±5.92 pg/ml, t=4.059, P＜0.01); FSH/LH ratio were lower than those of controls (0.38±0.12 vs. 1.33±0.38, t=-13.161, P＜0.01); LH/FSH ratio were higherthan those of controls (3.13±1.98 vs. 0.79±0.18, t=5.506, P＜0.01). There weresignificant differences between all of them. 3. Serum concentrations of INHB in womenwith PCOS were higher than those of the controls (92.06±14.64 vs. 78.82±5.81pg/ml, t=4.016, P＜0.01). 4. Basal serum INHB and LH were directly correlated in women withPCOS (r=0.594, P＜0.01). 5. In group A, basal serum INHB level and INHB levels on day10 of CC-induced ovulation were significantly higher than group B (P＜0.05), and basalserum INHB levels were (103.21±11.94), (82.88±9.37)pg/ml respectively, INHB levelson day 10 of CC-induced ovulation were (169.43±21.48), (109.29±16.24)pg/mlrespectively in groups A and B. 6. ROC analysis: day 10 INHB had the largest area undercurve (AUC) 0.992 (95％CI: 0.970-1.014), indicating that a threshold of 138.5pg/ml gave100％sensitivity, and 94.1％specificity.Conclusions: The high serum INHB levels in women with PCOS negatively influence thereproductive axis, and it is disadvantageous to follicle maturation. INHB is one of keyfactors for normal ovulation. The basal INHB levels and INHB levels on day 10 ofCC-induced ovulation may offer accurate and early prediction of ovarian reserve. Day 10INHB levels are the best predictor of ovarian reserve.
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