The effect of estradiol on granulosa cell responses to FSH in women with polycystic ovary syndrome

• Published in: Reproductive biology and endocrinology Vol. 15; no. 1; p. 13
• Main Authors: Homer, Michael V, Rosencrantz, Marcus A, Shayya, Rana F, Chang, R Jeffrey
• Format: Journal Article
• Language: English
• Published: England BioMed Central 10.02.2017
• Subjects: Adult; Aromatase Inhibitors - administration & dosage; Cohort Studies; Estradiol - blood; Female; Follicle Stimulating Hormone - administration & dosage; Granulosa Cells - drug effects; Granulosa Cells - metabolism; Humans; Inhibins - blood; Nitriles - administration & dosage; Polycystic Ovary Syndrome - blood; Time Factors; Triazoles - administration & dosage; Polycystic ovary syndrome; Granulosa cell; FSH; Inhibin B; Estradiol
• ISSN: 1477-7827; 1477-7827
• DOI: 10.1186/s12958-017-0230-0

The influence of estradiol (E ) on granulosa cell (GC) function has not been tested clinically in women with polycystic ovary syndrome (PCOS). The objective of this study is to determine if E influences GC responses to FSH in women with PCOS. This is a two phase, single cohort study conducted over a 2-year period at a single academic center. Nine women with PCOS according to NIH criteria. In Phase 1, FSH stimulation of GC responses as measured by E and Inhibin B (Inh B) were assessed before and at 5 and 6 weeks after GnRH agonist administration. In Phase 2, the same protocol was employed with the addition of an aromatase inhibitor (letrozole, LET) administered daily beginning at week 4 for 2 weeks. In Phase 1, recovery of FSH, E and Inh B from ovarian suppression occurred at 5 and 6 weeks after GnRH agonist injection and preceded resumption of LH and androgen secretion. In Phase 2, hormone recovery after GnRH agonist was characterized by elevated FSH and suppressed E levels whereas recovery of LH and androgen levels were unchanged. In Phase 1, FSH stimulated E and Inh B responses were unaltered during recovery from ovarian suppression. In Phase 2, E and Inh B fold changes after FSH were significantly reduced at weeks 5 (p < 0.04) and 6 (p < 0.01), respectively. In anovulatory women with PCOS, chronic, unopposed E secretion may contribute, at least in part, to enhanced ovarian responsiveness to FSH. NCT02389088.