Morphogenesis of polycystic ovaries as assessed by pituitary–ovarian androgenic function

Abstract Despite polycystic ovaries (PCO) being a common morphology in women with polycystic ovary syndrome and regular menstruation, the regulatory principles in the morphogenesis of antral follicles have not yet been elucidated. In recognition of the complementary interaction between androgen-indu...

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Published in:	Reproductive biomedicine online Vol. 18; no. 5; pp. 635 - 643
Main Authors:	Mori, Takahide, Nonoguchi, Kousuke, Watanabe, Hirohiko, Ishikawa, Hironobu, Tamura, Izuru, Kinoshita, Katsuji
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Ltd 2009
Subjects:	Adult antral follicle count Female folliculogenesis Gonadotropins, Pituitary - blood Humans hyper-LH hyperandrogenism Immunoassay Infertility, Female - etiology Morphogenesis - physiology Obstetrics and Gynecology Ovary - growth & development Ovary - pathology polycystic ovaries Polycystic Ovary Syndrome - classification Polycystic Ovary Syndrome - complications Polycystic Ovary Syndrome - pathology Statistics, Nonparametric Testosterone - blood folliculogenesis antral follicle count hyper-LH hyperandrogenism polycystic ovaries
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Summary:	Abstract Despite polycystic ovaries (PCO) being a common morphology in women with polycystic ovary syndrome and regular menstruation, the regulatory principles in the morphogenesis of antral follicles have not yet been elucidated. In recognition of the complementary interaction between androgen-induced expression of the FSH receptor and FSH-augmented expression of the androgen receptor in granulose cells of antral follicles, a possible correlation of antral follicle count (AFC) and pituitary–ovarian androgenic function was investigated in 180 infertile women over days 3–5 of the menstrual cycle. Six discrete types of PCO with decreasing pituitary–ovarian androgenic function were identified: Type I (classical Stein–Leventhal syndrome), Type II (hyperandrogenemism), Type III (singular hyper-LH), Type IV (cryptic hyperandrogenism), Type V (relative LH dominancy) and Type VI (relative FSH dominancy), in parallel to a diminishing number of AFC from Type I to Type VI. Because during the early follicular phase of the cycle until the selection of the dominant follicle, antral follicles are composed of newly emerged healthy follicles plus atretic antral follicles that remain non-ovulated from previous cycles, it is proposed that the six types of PCO may represent the folliculogenetic spectra along which PCO morphogenesis proceeds.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1472-6483 1472-6491
DOI:	10.1016/S1472-6483(10)60007-7