| Objective: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder in women of reproductive age, characterized by typical ovarian morphology, foilicular arrest and anovulation. The aetiology of PCOS has not fully elucidated.We collect PCOS case basis on the exclusion critera, and ivestigate three parts following:1. The concentrations of inhibin-B and follosatin were compared in women with PCOS who were untreated and normal women on day 3 of a cycle. Evaluate the effect of the two regulative factors inter-ovary in pathology and physiology of PCOS combined with LH> FSH> E2^ T and the result of B ultrasoun. 2. All th women with PCOS were received either urinary gonadotrophins (HMG) or recombinant FSH (r-FSH) with effective dose to induce ovulation. We will observe the change trend of inhibin-B and follosatin in the early follicular phrase and investigate the usefulness of inhibin-B and follosatin in predicting the follicular development and ovarian response.Methods: 1. In first part, we collect PCOS (n=32) and ontrols (n=24). They were not treated with steroids. Blood samples were taken on day 3 of the menstrual cycle. The samples were centrifuged and assayed . Ihibin-B and follistatin were measured by two-site enzyme-linked immunosorbent assay. Other hormones (LIU FSH, E2, T) were measured by immunochemist luminescence assay. Follicles were measured by B ultrasoun. Then compared each index between two groups. 2. All patients in the 'trested PCOS' group were injected every day intramuscularly with HMG or r-FSH (n=15)from the day 3 following spontaneous mense. The dose start at 75IU daily, adjusted depending on the follicular development. Follicular development wasmonitored by B ultrason from 3 day after treament and performed every 2 days. When a single follicle with mean diameter ≥18mm was seen, ovulation was induced by injection of HCG . Blood samples were obstained from the day before treament , 3 day and 6 day after treament, and the day before HCG injection. Hormones (E2, FSH, INH-B, FS) were measured by assays as described previously. Describe the change trend of each target and anlysis the correlation of the hormone and follicular development, then evaluate the monitoring function during treatment.Results: 1. T, INH-B and FS were significantly higher in women with PCOS than the control on day 3, but ? and FSH were significantly lower (T: 0.95±0.24(ng/ml) vs 0.68±0.32(ng/ml), PCOS vs control; INH-B: 128 + 41 (pg/ml) vs 91±24 (pg/ral), PCOS vs control; FS: 664±107 (pg/ral) vs 482±98 (pg/ml), PCOS vs control; E2: 52±14(pg/ml) vs 84±27 (pg/ml), PCOS vs control; FSH: 4.8±1.6(IU/L)vs 6.7±2.1 (IU/L) PCOS vs control) ( P<0. 05). 2. Three index including dose, time and the number of follicle were not different between the two treated groups when the dominant follicle appeared. At that time , the change trend of E2,FSH, INH-B, FS and the diameter of leading follicle in the treated groups was similar to that in control group. The change of E2 and INH-B was more marked, but the change of FS had no statistic significance. INH-B was higher in treated group than control from day 6 to the day of receiveing HCG. But situation E2and the diameter of leading follicle had the same situation from day 9 to the day of receiveing HCG. INH-B on day 6 was higher in treated group which had the dominant follicle than that had no the dominant follicle(INH-B: 214±74(pg/ml) vs 152±61 (pg/ml), the former vs the latter) (P<0.05) . 3. The ovarian response was defined by the number of follicles(≤ 10mm). In no-cancelled group, INH-B concentration was significantly positive correlated with the number of follicles on cycle day 6 and 9 (r1=0. 799, P<0. 01, r2=0. 830, P<0. 01); but E2concentration wasnot correlated with the parameters on day 6.Conclusion: 1.The current reseach suggested higher concentration of INH-B and FS change the level of T and E2 and inhibit the fuction of pituitary, then lead to numerous small antral follicles arrested and anovulation in PCOS. 2. It is certainly about the curative e... |
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