Dynamics of FSH-induced follicular growth in subfertile women: relationship with age, insulin resistance, oocyte yield and anti-Mullerian hormone

BACKGROUND: During excess FSH treatment, different categories of follicles can be discerned: those responding and appearing to grow immediately (FolsS8) and those appearing subsequently during the follicular phase (Fols/d). These follicular categories were explored in cycles of assisted reproduction...

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Bibliographic Details
Published in:Human reproduction (Oxford) 2006-06, Vol.21 (6), p.1436-1441
Main Authors: Fleming, R., Deshpande, N., Traynor, I., Yates, R.W.S.
Format: Article
Language:English
Subjects:
Adult
Age Factors
AMH
Anti-Mullerian Hormone
Biological and medical sciences
Body Mass Index
Cohort Studies
Female
follicle cohort
Follicle Stimulating Hormone - therapeutic use
FSH
Glycoproteins - metabolism
Gynecology. Andrology. Obstetrics
Humans
Infertility, Female - drug therapy
Insulin - metabolism
Insulin Resistance
Medical sciences
oocyte yield
Oocytes - metabolism
Ovarian Follicle - drug effects
Ovarian Follicle - metabolism
Ovulation Induction
PCOS
Polycystic Ovary Syndrome - drug therapy
Testicular Hormones - metabolism
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Summary:BACKGROUND: During excess FSH treatment, different categories of follicles can be discerned: those responding and appearing to grow immediately (FolsS8) and those appearing subsequently during the follicular phase (Fols/d). These follicular categories were explored in cycles of assisted reproduction in the context of follicular biology, including primordial follicle pool (PFP) depletion, age, insulin resistance and potential markers. METHODS: Follicular cohorts were examined in 365 conventional ART cycles and related to patient insulin sensitivity, plasma FSH and anti-Mullerian hormone (AMH). RESULTS: Age had no influence upon the FolsS8 category but was associated with a significant (P < 0.005) decline in the Fols/d. In contrast, insulin-resistant polycystic ovary syndrome (IR-PCOS) showed a significant (P = 0.005) increase in FolsS8. Circulating AMH correlated strongly with oocyte yield and Fols/d. CONCLUSION: Age showed little impact on the initial follicular cohort, but a significant impact upon the secondary cohort, while insulin resistance appeared to promote the former category alone. The disturbance to follicular dynamics and AMH in IR-PCOS reflected a larger stockpile of FSH-sensitive follicles. Circulating AMH appears to represent all categories of antral follicles observed.
ISSN:0268-1161
1460-2350
DOI:10.1093/humrep/dei499