Expression of HBsAg and HBcAg in the ovaries and ova of patients with chronic hepatitis B

AIM： To investigate the expression and distribution of HBV in the ovaries and ova. METHODS： The immunohistochemistry method was used to detect the HBsAg and HBcAg in the ovaries of patients with chronic hepatitis B. RESULTS： Expression of HBsAg in the ova, granular and interstitial cells of the ovaries was located in the cytomembrane and cytoplasm. Expression of HBcAg in the ova, granular, interstitial and endothelial cells of interstitial blood vessels of the ovaries was found in the cytomembrane, cytoplasm, and nuclei. CONCLUSION： HBV can infect the ova at different stages of development and replicate in it. 2005 The W3G Press and Elsevier Inc. All rights reserved.

Differential Proteomics Reveals the Potential Injury Mechanism Induced by Heavy Ion Radiation in Mice Ovaries

In the present study, we used a proteomics approach based on a two-dimensional electrophoresis （2-DE） reference map to investigate protein expression in the ovarian tissues of pubertal Swiss-Webster mice subjected to carbon ion radiation （CIR）. Among the identified proteins, ubiquitin carboxy-terminal hydrolase L1 （UCH-L1） is associated with the cell cycle[1] and that it influences proliferation in ovarian tissues. We analyzed the expression of UCH-L1 and the proliferation marker proliferation cell nuclear antigen （PCNA） following CIR using immunoblotting and immunofluorescence. The proteomics and biochemical results provide insight into the underlying mechanisms of CIR toxicity in ovarian tissues.

Congenital ovarian anomaly manifesting as extra tissue connection between the two ovaries:A case report

BACKGROUND Ovarian anomalies except for uni-or bilateral streak gonads are rare.We present a rare case of an ovarian anomaly in which both ovaries were connected by extra tissue.CASE SUMMARY A 32-year-old,primipara with a twin pregnancy at 36 weeks of gestation was admitted to the hospital with severe preeclampsia.She underwent emergency cesarean section owing to persistent headache,blurred vision,and general edema.Following a peritoneal incision,a thin rectangular-shaped tissue was seen in front of the uterus.After delivery,the extra tissue was removed;no other anomalies were reported in either the ovaries or uterus.Pathology results of the removed tissue disclosed a well-vascularized loose stromal tissue with few follicles and scattered luteinized cells.In this case,to prevent pelvic adhesion or intestinal obstruction resulting from volvulus,strangulation,and torsion,the extra tissue was removed.CONCLUSION We report a case of a rare ovarian anomaly where both ovaries were connected by extra tissue.If the extra tissue extends to the abdominal cavity,it should be removed to prevent pelvic adhesion or abdominal complications including intestinal volvulus,strangulation,and torsion.

Early Warning System of Risk in Dairy Cows with Inactive Ovaries

The incidence of Inactive ovaries of dairy cows in China is relatively high. There is no complete early warning system for the occurrence of ovarian quiescence in clinical cows. This test provides early warning indicators for clinical prediction of ovary cessation in dairy cows. This experiment selected blood samples of dairy cows from 60 to 90 days postpartum in the inactive ovaries group and control group. Differential proteins were selected on the basis of proteomics, three energy indexes: AST, Glu, NEFA. Four reproductive hormones: E2, P4, FSH, LH, and four differentially expressed proteins: IGFBP-2, AHSG, APO-A4, and RBP-4. Key enzyme activities: ALDOB, LDHB, ITIH3, GPX3, SPAM1, PKM2. The ELISA test kit was used to detect the content and activity of the above markers in the test bovine serum. Through correlation analysis, binary logistic regression modeling and ROC analysis, a single indicator early warning technique for APOA4 and ITIH3 was established. The early warning values were APOA4 > 28.825 μg/L and ITIH3 > 195.07 ng/L. A multi-index early warning system based on potential biomarkers of APOA4 + ITIH3 and APOA4 + ITIH3 + E2 was established. The former had an early warning value of: APOA4 > 19.55 μg/I;ITIH3 > 191.14 ng/L;the latter has an early warning value: APOA4 > 47.56 μg/L, ITIH4 > 187.80 ng/L, E2 < 69.63 ng/L.

Sonographic evaluation of mullerian anomalies in women with polycystic ovaries

Background: Mullerian anomalies are relatively common and contributing to the problems of infertility and poor pregnancy outcomes. But their molecular pathophysiology has been insufficiently studied. On the other hand, polycystic ovary syndrome (PCOS) is found in nearly 80% of women with hyperandrogenism and also in 8%-25% of normal ones. It seems that anti-mullerian hormone (AMH) which inhibits the formation of the mullerian ducts in male increases in women with PCOS. Therefore, the aim of the study is whether PCOS is associated with mullerian anomalies. Methods: In this case-control study, 83 women with PCOS and 83 cases without PCOS were evaluated with transvaginal ultrasound (TVS) for the diagnosis of mullerian anomalies. The results of each group were compared with other groups. Results: In the PCOS patients, TVS revealed mullerian anomalies in the uterine cavity in 29 out of 83 women. Among 29 patients who had lesions in their uterine cavity, 27 cases had septate uterus and two had arcuate uterus. In the healthy women, TVS revealed 6 septate uterus and 4 arcuate uterus abnormality cases of the uterine cavity. There were significant correlation between polycystic ovary syndrome of the patients and the mullerian anomalies lesions (i.e. septate and arcuate uterus) which were seen in them. Conclusion: Mullerian anomalies were more common in women with PCOS and the most common anomaly was uterine septum. In fact, the present results revealed that it seemed a cause-effect relationship between the mullerian anomalies and PCO syndrome may in fact exist.

Squamous cell carcinoma associated with endometriosis in the uterus and ovaries:A case report

BACKGROUND Endometriosis is a common benign gynecological disease that causes dysmenorrhea in women of childbearing age.Malignant tumors derived from endometriosis are rarely reported and are found in only 1%of all patients with endometriosis.Here,we report a well-differentiated squamous cell carcinoma(SCC)caused by squamous metaplasia of endometriosis that co-occurred in the uterus and ovaries.CASE SUMMARY A 57-year-old postmenopausal woman had a 6-month history of irregular uterine bleeding.The uterus and adnexa were examined by computed tomography,and there were two solid cystic masses in the pelvis and right adnexa.Histological findings of surgical specimens showed well-differentiated SCC arising from squamous metaplasia of ectopic endometrial glands in the uterus and ovaries.The patient received chemotherapy after surgery and was followed up for 3 mo without metastasis.CONCLUSION The continuity between ectopic endometrial glands and SCC supports that SCC originates from ectopic endometrial glands with metaplasia towards squamous epithelium.

Rare Infantile Inguinal Hernia Containing Uterus, Ovaries and Fallopian Tubes—A Case Report: Presentation from Yemen

The presence of ovaries and fallopian tubes in the sac of female inguinal hernia is rare especially in childhood. However, complete herniation of the uterus side by side with ovaries and tubes constitutes extreme rarity. We herein present a 6-years old female patient whose inguinal hernia contains uterus in addition to ovaries and fallopian tubes. The aim of this report is to attract attention of surgeons to this rare possibility during surgical management of hernia in order to avoid the likely damage to herniated structures.

Identification of Novel and Differentially Expressed MicroRNAs in the Ovaries of Laying and Non-Laying Ducks

MicroRNAs （miRNAs）, which post-transcriptionally regulate gene expression by binding to the 3′untranslated region of mRNAs to either inhibit or enhance translation, are involved in diverse biological processes. The use of high-throughput Solexa sequencing plays important roles in the discovery of miRNAs. In this study, we used high-throughput Solexa sequencing to identify novel duck miRNAs and compare the miRNA expression profiles in laying and non-laying duck ovaries. Using a bioinformatic analysis, we discovered 86 potential duck miRNAs similar to known chicken miRNAs and 43 unique sequences that matched known miRNAs of other species. We also found that miRNA variations and isoforms were widespread in our two RNA libraries, with most of the variations occurring in the 3′region of the miRNAs. Furthermore, we detected 55 miRNAs that exhibited significant expression differences between laying and non-laying ducks. Gene ontology （GO） and kyoto encyclopedia of genes and genomes （KEGG） enrichment analyses of the potential targets of the differentially expressed miRNAs indicated these miRNAs may play key roles in the egg laying process. Finally, we confirmed the differential expression of 5 miRNAs in the laying and non-laying samples by qRT-PCR. Cumulatively, our work provides the first look at the miRNA expression profile of the duck ovary and provides novel insight into the roles of miRNAs in egg laying and reproduction.

Effects of Zn^(2+) and Cu^(2+) on loach ovaries and ova development

This study compared the accumulation of Zn2+and Cu2+in the ovaries and ova of loaches under different concentrations of Zn2+(1.00, 2.50 and 5.00 mg/L respectively) and Cu2+(0.10, 0.25 and 0.50 mg/L respectively). The results showed that both Zn2+and Cu2+accumulated in the ovaries, and that the relationship between accumulation and time was linear over 20 days of exposure. The accumulation of the metals in ovaries was closely related to the concentration of exposure in the solutions(P<0.05), and was obviously affected by the time and doses. However, the Cu2+concentration was significantly higher than Zn2+(P<0.05). The development level of ova in the ovaries also correlated with the concentration and exposure period in the Zn2+and Cu2+solutions.

Endocrine Indices of PCOS in Women with Polycystic Ovaries but without Diagnostic Features of PCOS: A Study of an Infertility Clinic Population

Background: The presence of polycystic ovarian morphology (PCO) without the other characteristics of the polycystic ovarian syndrome (PCOS) is insufficient for the diagnosis of PCOS and there is little justification for follow up in endocrine clinics for women with PCO morphology alone. A few studies have been reported regarding the endocrine features of asymptomatic women with PCO with conflicting data about endocrine profiling. The aim of this study was to assess whether women with PCO, but who have no symptoms of PCOS differ, endocrinologically, from women with normal ovaries.?Methods: We analysed the results of ultrasound and endocrine investigations in 576 consecutive women who attended the infertility clinic between 1993 and 1995 at the Reproductive Medicine Unit of St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK. Results: Three hundred and twenty eight women had PCO and 248 had normal ovaries. Among the 328 women with PCO, 169 (51.5%) had PCOS according to Rotterdam criteria. The remaining women with PCO had no symptoms of the syndrome (n = 159);they had a history of regular menses, had proven ovulatory cycles and had neither clinical nor biochemical evidence of hyperandrogenism. However, these women had higher timed LH [median (IQR) 5.3 (4.2) IU/l vs 4.8 (3.4) IU/l, respectively;p = 0.044] and testosterone [2.0 (0.8) nmol/l vs 1.8 (0.8), respectively;p = 0.009] compared with women with normal ovaries (although by definition within the normal range). There was no difference in BMI or FSH between the two groups. Among the 169 women with PCOS, 45.0% (n = 76) were anovulatory without hyperandrogenism, 34.3% (n = 58) fulfilled the NIH criteria and 20.7% (n = 35) were ovulatory with hyperandrogenism. The proportion of hyperandrogenism among anovulatory women with PCO is 43.3% (58 out of 134).?Conclusions: Women with PCO, but no symptoms of the syndrome, differ endocrinologically compared with women with normal ovaries: they had higher timed LH and testosterone (although by definition within the normal range). These data suggest that despite the lack of symptoms of PCOS, women presenting to an infertility clinic with PCO represent a milder phenotype of those with overt PCOS, but fall on the same spectrum.

Metastatic low-grade endometrial stromal sarcoma with variable morphologies in the ovaries and mesentery: A case report

BACKGROUND Low-grade endometrial stromal sarcoma(LGESS)classically exhibits a proliferative morphology.However,morphological variation of extrauterine tumors presents a diagnostic challenge.CASE SUMMARY We report the case of a 76-year-old female patient with extensive extrauterine and abdominal neoplastic lesions.Computed tomography showed massive pleural and ascitic fluid,and there was an increase in serum cancer antigen 125.She underwent bilateral adnexectomy and tumor resection.The right ovary had been replaced by a multinodular mass that was 8.5 cm×4.5 cm×3.5 cm in size.In addition,there was a 24 cm×15 cm×13 cm mesenteric mass,which was also multinodular,with local invasion of the intestinal serosa and underlying muscle.Under the microscope,the tumors in different places exhibited two different patterns,thus presenting great challenges to diagnosis and treatment.Thorough pathological assessment eliminated all differential diagnoses in favor of metastatic LGESS derived from a 20-year-old primary tumor initially misdiagnosed as leiomyosarcoma.CONCLUSION LGESS morphology varies according to tumor location.Accurate diagnosis is critical for appropriate treatment and improved prognosis and patient care.

Qualitative and quantitative analysis of goat ovaries, follicles and oocytes in view of in vitro production of embryos

Goat ovaries were collected from the slaughterhouse and categorized as right, left, corpus luteum （CL）-present and -absent group and evaluated on the basis of weight （g）, length （cm）, width （cm）, number of follicles, follicles aspirated and number and state ofcumulus-oocyte-complexes （COCs）. Comparatively higher weight [（0.66±0.02） vs （0.64±0.02） g], length [（1.17±0.02） vs （1.1 ±0.02） cm] and width [（0.77±0.02） vs （0.74±0.02） cm] were found in right ovaries than those of left. On the other hand significantly （P〈0.05） higher weight [（0.71±0.03） vs （0.64±0.01） g] and width [（0.76±0.03） vs （0.75±0.01） cm] were found in CL-present group than those of CL-absent group of ovaries. The left ovaries contained comparatively higher number of normal COCs [（1.06±0.09） per ovary] than fight ovaries [（1.03±0.10） per ovary] and the similar trend was found in total number of follicles [（4.51±0.25） vs （4.30±0.23） per ovary] and follicles aspirated [（2.55±0.14） vs （2.52±0.12） per ovary]. But the total COCs per ovary was almost similar in both ovaries [right and left： （1.85±0.12） and （1.85±0.11） per ovary, respectively]. Higher number of total COCs [（1.87±0.09） vs （1.76±0.16） per ovary], total number of follicles [（4.45±0.19） vs （4.16±0.37） per ovary], follicles aspirated [（2.55±0.10） vs （2.48±0.21） per ovary] and normal COCs [（1.12±0.07） vs （0.76±0.14） per ovary] were found in CL-absent group than those of CL-present group of ovaries.

Flutamide-induced alterations in transcriptional profiling of neonatal porcine ovaries

Background: Androgens are involved in the regulation of ovarian development during fetal/neonatal life.Environmental chemicals displaying anti-androgenic activities may affect multiple signal transduction pathways by blocking endogenous androgen action.The aim of the current study was to examine effects of the anti-androgen flutamide on the expression of coding transcripts and long non-coding RNAs(lncRNAs) in neonatal porcine ovaries.By employing RNA-Seq technology we aimed to extend our understanding of the role of androgens in neonatal folliculogenesis and examine the impact of the anti-androgen flutamide on ovarian function.Method: Piglets were subcutaneously injected with flutamide(50 mg/kg BW) or corn oil(controls) between postnatal days 1 and 10(n = 3/group).Ovaries were excised from the 11-day-old piglets and total cellular RNAs were isolated and sequenced.Results: Flutamide-treated piglet ovaries showed 280 differentially expressed genes(DEGs;P-adjusted < 0.05 and log2 fold change ≥1.0) and 98 differentially expressed lncRNAs(DELs;P-adjusted < 0.05 and log2 FC ≥ 1.0).The DEGs were assigned to GO term,covering biological processes,molecular functions and cellular components,which linked the DEGs to functions associated with cellular transport,cell divisions and cytoskeleton.In addition,STRING software demonstrated strongest interactions between genes related to cell proliferation.Correlations between DEGs and DELs were also found,revealing that a majority of the genes targeted by the flutamide-affected lncRNAs were associated with intracellular transport and cell division.Conclusions: Our results suggest that neonatal exposure of pigs to flutamide alters the expression of genes involved in ovarian cell proliferation,ovarian steroidogenesis and oocyte fertilization,which in turn may affect female reproduction in adult life.

Effects of Zn^(2+) and Cu^(2+) on loach ovaries and ova development

This study compared the accumulation of Zn^(2+)and Cu^(2+)in the ovaries and ova of loaches under different concentrations of Zn^(2+)(1.00,2.50 and 5.00 mg/L respectively)and Cu^(2+)(0.10,0.25 and 0.50 mg/L respectively).The results showed that both Zn^(2+)and Cu^(2+)accumulated in the ovaries,and that the relationship between accumulation and time was linear over 20 days of exposure.The accumulation of the metals in ovaries was closely related to the concentration of exposure in the solutions(P<0.05),and was obviously affected by the time and doses.However,the Cu^(2+)concentration was significantly higher than Zn^(2+)(P<0.05).The development level of ova in the ovaries also correlated with the concentration and exposure period in the Zn^(2+)and Cu^(2+)solutions.

Molybdenum and cadmium co-induce necroptosis through Th1/Th2 imbalance-mediated endoplasmic reticulum stress in duck ovaries

Cadmium(Cd)and excess molybdenum(Mo)pose serious threats to animal health.Our previous study has determined that Cd and/or Mo exposure can cause ovarian damage of ducks,while the specific mechanism is still obscure.To further investigate the toxic mechanism of Cd and Mo co-exposure in the ovary,forty 8-day-old female ducks were randomly allocated into four groups for 16 weeks,and the doses of Cd and Mo in basic diet per kg were as follows:control group,Mo group(100 mg Mo),Cd group(4 mg Cd),and Mo+Cd group(100 mg Mo+4 mg Cd).Cadmium sulfate 8/3-hydrate(CdSO_(4)·8/3H_(2)O)and hexaammonium molybdate((NH_(4))_(6)Mo_(7)O_(24)·4H_(2)O)were the origins of Cd and Mo,respectively.At the 16th week of the experiment,all ovary tissues were collected for the detection of related indexes.The data indicated that Mo and/or Cd induced trace element disorders and Th1/Th2 balance to divert toward Th1 in the ovary,which activated endoplasmic reticulum(ER)stress and then provoked necroptosis through triggering RIPK1/RIPK3/MLKL signaling pathway,and eventually caused ovarian pathological injuries and necroptosis characteristics.The alterations of above indicators were most apparent in the joint group.Above all,this research illustrates that Mo and/or Cd exposure can initiate necroptosis through Th1/Th2 imbalance-modulated ER stress in duck ovaries,and Mo and Cd combined exposure aggravates ovarian injuries.This research explores the molecular mechanism of necroptosis caused by Mo and/or Cd,which reveals that ER stress attenuation may be a therapeutic target to alleviate necroptosis.

Cell-specific expression and immunolocalization of nitric oxide synthase isoforms and the related nitric oxide/cyclic GMP signaling pathway in the ovaries of neonatal and immature rats

Objective: The present study is designed to investigate the cellular expressions and immunolocalizations of three different nitric oxide synthase (NOS) isoforms and the related nitric oxide (NO)/cyclic guanosine monophosphate (cGMP) signaling pathway in the ovaries of neonatal and immature rats.Methods: The ovaries were obtained from ICR (Institute for Cancer Research) female Sprague-Dawley rats at postnatal days 1,5,7,10,and 19.Then we carried out the histologic examination,immunohistochemistry,measurement of NOS activity,and modifications within the NO/cGMP pathway.Results: During postnatal days 1,5,7,10,and 19,all three isoforms of NOS were mainly localized to the oocytes and expressed as a gradual increase in granulosa cells and theca cells within the growing follicle.The ovarian total NOS activities and NO levels were increased at postnatal days 7 and 10 compared with other days.Conclusions: Our findings suggest that the locally produced NO and the NO/NOS signaling systems are involved in the follicular development to puberty.

Occurrence of a nematode Philometra(Costa,1845)in the ovaries of Epinephelus malabaricus(Bloch&Schneider,1801)in southeast coast of India

Objective:To study the prevalence of philometrid nematode,Philometra spp.infected in the ovaries of Epinephelus malabaricus(E.malabaricus)from southeast coast of India.Methods:Totally 4801 fishes were collected from Mandabam,Tuticorin and Kanyakumari.The normal and infected ovaries were carefully removed from dissected fishes and the prevalence of nematode infection for each fish was examined.Then the nematode were carefully removed and washed in a 0.6%saline solution and fixed in 70%ethanol.Representative nematodes were cleaned with glycerin and fixed in a solution of 95%glacial acitic acid and 5%formalin for identification under light microscopy.Results:Of which 16.8%,16.2%and 14.7%parasitic prevalence was observed from Mandabam,Tuticorin and Kanyakumari respectively.The intensity of parasitic worms per fish varied from 1 to 8 with an average of 6.33±0.84.Nematode length varies from 7-22 mm with in average of(18.70±4.57)mm.The average length and weight of E.malabaricus were(332.950±77.792)mm and(513.30±169.46)g respectively.Conclusions:It can be assumed that females of this nematode are unable to attain gravidity in this host species,and consequently,E.malabaricus does not serve as the true definitive host of Philometra spp.Prevalence of infection and intensity of the nematode are highly effected by sucking blood,causing atrophy of developing ova in the ovary,fibrosis of ovarian tissue,increasing granulocytes and haemorrhages,and thus negatively affecting the reproduction of some species of E.malabaricus.

Comparative transcriptomic analysis of ovary and testis reveals sex-related genes in roughskin sculpin Trachidermus fasciatus

The mechanisms underlying sex determination and differentiation have long intrigued researchers in the fields of development and evolutionary biology.The roughskin sculpin(Trachidermus fasciatus Heckel),displaying sexual dimorphism,provides an ideal model for studying the mechanisms.However,both genetic and genomic information concerning sex determination and differentiation,such as gonadal transcriptome data in roughskin sculpin,are lacking.Here,we present the first gonadal transcriptomes of roughskin sculpin and identify sex-related genes.We identified 8531 differentially expressed genes(DEGs),among them 4065 were upregulated in the ovary and 4466 upregulated in the testis.Several sex-related gene ontology(GO)terms were enriched in ovary-biased genes,including“binding of sperm to zona pellucida”,“egg coat formation”,“positive regulation of acrosome reaction”,“cell division”,and“cell cycle”,while the GO terms such as“spermatogenesis”,“sperm axoneme assembly”,“cilium assembly”,“cilium movement”,and“cilium movement involved in cell motility”were enriched in testis-biased genes.Moreover,six KEGG pathways were significantly enriched in the ovary,whereas only one was enriched in the testis.Of these DEGs,40 sex-related genes were identified,which including 26 testis-biased genes(such as Dmrtb 1,Gsdf,Sox 9 b,Wnt 4 b,Tcp 11 l 2,and Efhb),and 14 ovary-biased genes(such as Cyp 19 a 1 a,Foxh 1,Foxr 1,Gdf 3,Hsd 17 b 12,and Igf 2 bp 3).This gonadal transcript dataset would broaden our understanding of sex determination and differentiation mechanisms in roughskin sculpin,expand the genomic database,support future studies on sex-related gene functions,and facilitate molecular biology research into roughskin sculpin.

RNA m6A dynamic modification mediated by nucleuslocalized FTO is involved in follicular reserve

In eukaryotic organisms,the most common internal modification of messenger RNA(m RNA)is N6-methyladenosine(m6A).This modification can be dynamically and reversibly controlled by specific enzymes known as m6A writers and erasers.The fat-mass and obesity-associated protein(FTO)catalyzes RNA demethylation and plays a critical role in various physiological and pathological processes.Our research identified dynamic alterations in both m6A and FTO during the assembly of primordial follicles,with an inverse relationship observed for m6A levels and nuclear-localized FTO expression.Application of Fto small interfering RNA(si RNA)altered the expression of genes related to cell proliferation,hormone regulation,and cell chemotaxis,and affected RNA alternative splicing.Overexpression of the full-length Fto gene led to changes in m6A levels,alternative splicing of Cdk5,cell proliferation,cell cycle progression,and proportion of primordial follicles.Conversely,overexpression of Fto lacking a nuclear localization signal(NLS)did not significantly alter m6A levels or primordial follicle assembly.These findings suggest that FTO,localized in the nucleus but not in the cytoplasm,regulates RNA m6A demethylation and plays a role in cell proliferation,cell cycle progression,and primordial follicle assembly.These results highlight the potential of m6A and its eraser FTO as possible biomarkers and therapeutic targets.

Association between Metal(loid)Exposure and Risk of Polycystic Ovary Syndrome Mediated by Anti-Müllerian Hormone among Women Undergoing In Vitro Fertilization and Embryo Transfer

Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age.Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively.Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk.Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.