Age-related differences in features associated with polycystic ovary syndrome in normogonadotrophic oligo-amenorrhoeic infertile women of reproductive years

Abstract

Objective: To assess the effect of age on clinical, endocrine and sonographic features associated with polycystic ovary syndrome (PCOS) in normogonadotrophic anovulatory infertile women of reproductive years. Design: Cross-sectional study. Methods: Four hundred and seventy-two oligo-amenorrhoeic infertile patients, presenting with normal FSH and oestradiol concentrations, aged 17±42 years underwent a standardised initial evaluation including: cycle history, body mass index, waist-to-hip ratio and transvaginal ultrasound scanning of ovaries. Fasting blood samples were obtained for extensive endocrine evaluation. Cycle duration, serum levels of gonadotrophins, androgens, oestradiol, insulin, glucose, inhibin B as well as mean number of follicles, ovarian volume and ovarian stroma echogenicity were assessed. Results: Older women had signi®cantly lower LH and androgen and inhibin B serum levels. Similarly, older women presented with a reduced number of ovarian follicles. Age was inversely correlated with cycle duration r 20X112Y P 0X02Y LH r 20X154Y P 0X001Y testosterone r 20X194Y P 0X001Y androstenedione r 20X170Y P 0X001Y dehydroepiandrosterone r 20X157Y P 0X001Y insulin r 20X126Y P 0X02Y inhibin B r 20X118Y P 0X03 serum levels and mean follicle number r 20X100Y P 0X03X A positive correlation was observed between age and glucose to insulin ratio r 0X138Y P 0X009X Conclusions: Advanced age in normogonadotrophic anovulatory infertile women is associated with lower LH and androgen levels and with a decreased number of ovarian follicles. Although during reproductive years observed differences are relatively small, these age-related changes may affect the observed incidence of PCOS. European Journal of Endocrinology 145 749±755

Diverse impacts of aging on insulin resistance in lean and obese women with polycystic ovary syndrome: evidence from 1345 women with the syndrome

“…Additionally, in either pre-or postmenopausal normal women, a direct relationship between androgen levels and IR or DM risk has been determined (40,41). In women with PCOS, but also in controls, androgen levels gradually decrease through time, as has been shown in several studies (42,43,44,45) and confirmed in the present one. However, it should be emphasized that androgens decreased irrespective of the BMI, implying that the association of androgens with age is direct and not through obesity.…”

Anti-Müllerian Hormone Serum Concentrations in Normoovulatory and Anovulatory Women of Reproductive Age

“…Hence, increased intraovarian AMH production in PCOs may slow down the process of primordial follicle recruitment and thus retard depletion of the primordial follicle pool. Although it has been reported that cycle irregularities and hormonal profiles improve with increasing age (37)(38)(39), data regarding the age of menopause in these women are lacking. However, menopausal age in these women is difficult to establish because most of them will regulate their cycles up to advanced age using oral contraceptive pills.…”

Long-term consequences of polycystic ovary syndrome on cardiovascular risk

“…Several studies have shown that androgen secretion spontaneously decreases after the age of 35 in normal and PCOS women (34,35) and that in the general population the prevalence of polycystic ovaries appears to decrease with age too (36). Further, women with polycystic ovaries may regain normal menses with age (37) and may also get spontaneous fertility (38).…”