35-40岁多囊卵巢综合征患者卵巢功能研究

Evaluation of ovarian function in 35-40-year-old women with polycystic ovary syndrome

目的研究生育能力开始下降的多囊卵巢综合征（PCOS）患者体内促性腺激素、卵巢类固醇和PCOS卵巢储备情况,并探讨其卵巢功能。方法 40例35-40岁PCOS患者和35名健康妇女纳入本次研究。详细了解患者病史、并对患者进行常规体格检查、阴式超声检测和醋酸亮丙瑞林测试。此外,还检测了促性腺激素、类固醇激素、性激素结合球蛋白、抑制素B和AMH的含量。结果两组LH的低值和峰值水平相近。FSH低值和峰值水平分别显著高于正常对照组。PCOS患者组的雄激素、雌二醇峰值、卵巢体积、窦状卵泡数目和AMH水平均显著高于正常对照组。结论晚育PCOS患者体内的促性腺激素分泌显著区别于对照组女性,且可能与年轻的PCOS妇女有显著区别。女性高卵巢储备的新特征如正常LH和低FSH水平可能带给她们不同的生殖情况。

【Objective】To assess gonadotrophin secretion, ovarian steroid production and ovarian reserve in PCOS women during the onset of reproductive decline, in order to characterize their ovarian function at this age.【Methods】Forty PCOS patients and 35 healthy women（35-40 years of age） were included. Clinical history, anthropometry,transvaginal ultrasound and a leuprolide acetate test（10 mg/kg s.c.） were performed. Gonadotrophins, steroid hormones, SHBG, inhibin B and AMH were determined. 【Results】Basal and peak LH levels were similar in both groups. Basal and peak FSH levels were significantly higher in the control group. Androgens, peak oestradiol, ovarian volume, antral follicle count and AMH levels were significantly higher in PCOS patients. 【Conclusions】These observations suggest that during late reproductive age, gonadotrophin secretion in women with PCOS is clearly different from that observed in control women and may also differ from that of younger PCOS patients. New features like normal LH and lower FSH levels associated with a higher ovarian reserve may give a different reproductive profile to these women.