Quantitative Differences in TGF-[beta] Family Members Measured in Small Antral Follicle Fluids From Women With or Without PCO

Context: Members of the TGF-[beta] family have been implicated in aberrant follicle development in women with polycystic ovaries (PCO). Objective: Are there quantitative differences in the concentrations of TGF-[beta] family membersin fluid from human small antral follicles (hSAFs) in women with or without PCO? Design and Setting: Follicle fluids (FFs) were collected from 4- to 11-mm hSAFs obtained from women undergoing ovarian tissue cryopreservation for fertility preservation. Patients: FFs from 16 women with PCO (FF = 93) and 33 women without PCO (FF = 92). Main Outcome Measures: Intrafollicular concentrations of growth differentiation factor-9 (GDF9); anti-Mullerian hormone (AMH); inhibin-A and inhibin-B; total inhibin; activin-A, activin-B, and activin-AB; follistatin; follistatin-like-3; estradiol; and testosterone. Results: Activin-B concentrations were reported in hSAFs, and concentrations were 10 times higher than activin-A and activin-AB concentrations. Activin-B showed significant associations with other growth factors. Concentrations of inhibin-A and inhibin-B were significantly lower in FFs from women with PCO, especially in hSAFs 6 mm. Conclusions: Altered concentrations of TGF-[beta] family members in hSAFs from women with PCO highlight altered growth factor signaling as a potential mechanism for follicle growth arrest. (J Clin Endocrinol Metab 104: 6371-6384, 2019)