Elevation of antimüllerian hormone in women with polycystic ovary syndrome undergoing assisted reproduction: effect of insulin
To measure blood and follicular antimüllerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) undergoing assisted reproductive technologies (ART) and to examine the direct action of insulin on AMH expression in human granulosa cells. Prospective clinical and experimental study. U...
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Veröffentlicht in: | Fertility and sterility 2019-01, Vol.111 (1), p.157-167 |
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Zusammenfassung: | To measure blood and follicular antimüllerian hormone (AMH) levels in women with polycystic ovary syndrome (PCOS) undergoing assisted reproductive technologies (ART) and to examine the direct action of insulin on AMH expression in human granulosa cells.
Prospective clinical and experimental study.
University Hospital-based laboratory.
Women with (n = 86) and without (n = 172) PCOS in ART.
Blood, follicular fluid, and luteinized granulosa cells were collected from PCOS and non-PCOS women in ART.
Hormone levels in blood and fluid, and gene expression in granulosa cells.
Serum levels of AMH were elevated and inversely correlated with embryo cleavage rate in PCOS women in ART. Significant higher levels of AMH were also found in small and large follicles collected from PCOS women compared with non-PCOS women. Luteinized granulosa cells from PCOS women showed higher expression of AMH and its receptor AMHR2. Direct effect of insulin in increasing the expression of AMH in the isolated luteinized granulosa cells was observed, with the PCOS granulosa cells responding to a high dose of insulin. Cotreatment with AMH attenuated insulin-induced aromatase expression in the luteinized granulosa cells.
These results suggest that insulin may contribute to AMH elevation in PCOS and that AMH counteracts insulin-promoted aromatase expression in granulosa cells.
Elevación de la hormona antimülleriana en mujeres con síndromede ovario poliquístico sometidas a reproducción asistida: efecto de la insulina.
Medir los niveles sanguíneos y foliculares de hormona antimülleriana (AMH) en mujeres con síndrome de ovario poliquístico (SOP) sometidas a técnicas de reproducción asistida (TRA) y examinar la acción directa de la insulina sobre la expresión de AMH en células de la granulosa humanas.
Estudio prospectivo clínico y experimental.
Laboratorio de hospital universitario.
Mujeres con (n = 86) y sin (n = 172) SOP en TRA.
Se tomaron muestras de sangre, líquido folicular y células de la granulosa luteinizadas en mujeres en TRA con SOP y sin SOP.
Niveles hormonales en sangre y líquido folicular, y expresión génica en las células de la granulosa.
Los niveles séricos de AMH fueron elevados y se correlacionaron inversamente con la tasa de división del embrión en mujeres con SOP en TRA. También se encontraron niveles significativamente más altos de AMH en los folículos pequeños y grandes de mujeres con SOP en comparación con mujeres sin SOP. Las células de la granulosa luteinizadas de las muje |
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ISSN: | 0015-0282 1556-5653 |
DOI: | 10.1016/j.fertnstert.2018.09.022 |