Search

In order to investigate the pathological characteristics of polycystic ovaries diagnosed by transvaginal ultrasound (TVS) in patients with polycystic ovarian syndrome (PCOS) and to investigate the relationship between morphological and endocrine changes in the ovaries, 32 PCOS patients with bilateral polycystic ovaries (10 cysts) detected by TVS were studied; 20 ovulatory women served as controls. Ovarian tissues from wedge resection were examined histologically. A comparative histological and TVS study of ovarian morphology was made, and the relationship between the number of small cysts and the endocrine profile was examined. The position and size of small cysts on TVS agreed with those observed histologically. There was a significant correlation between the number of small cysts on TVS and the number of atretic follicles with hypertrophied and luteinized inner theca cells, and thickened ovarian capsules. Numerous atretic follicles and thickened ovarian capsules were observed in 97 and 64% of ovaries respectively, from PCOS patients. In patients with PCOS, a significant positive correlation was noted both between the number of small cysts and delta 4-androstenedione (ASD), and between ASD and the luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio. Furthermore, testosterone, ASD and the number of small cysts on TVS were significantly higher in PCOS patients with ovarian thickened tunica compared to PCOS patients without ovarian thickened tunica. TVS images of ovaries in patients with PCOS correlated with the histopathological and endocrine features. It is suggested that an increase in intra-ovarian small cysts leads to increased production of ovarian androgen, in turn influencing the secretion of gonadotrophin, and is correlated with ovarian capsular thickness.

In order to investigate the androgen and sex hormone binding globulin (SHBG) levels in the polycystic ovary, we compared the total testosterone, free testosterone and SHBG levels in three patterns of polycystic ovary diagnosed with transvaginal ultrasonography (18 in group 1, fewer than 5 cysts identified; 16 in group 2, 5-10 cysts; and 27 in group 3, 10 or more). Free testosterone, but not total testosterone, significantly correlated with body mass index. Androgen levels were found to increase and SHBG levels to decrease with increases in the amount of ovarian cysts, and the evaluation of free testosterone was important in diagnosing the polycystic ovary syndrome.

To investigate the catecholamine status of patients with polycystic ovary syndrome.Three parallel groups with polycystic ovary were diagnosed by ultrasound: (a) 5 patients with regularly ovulatory menstruation; (b) 10 with anovulatory menstruation; (c) 13 with secondary amenorrhea who responded to progestagen with withdrawal bleeding. Blood samples for measurement of LH, testosterone, and catecholamine metabolites were drawn during cycle days 4-7.(1) Serum LH and testosterone of the patient groups (b) and (c) were significantly higher than those of controls. (2) Plasma 3,4-dihydroxyphenylglycol (DOPEG) and the DOPEG/DOPAC ratio were elevated in patients, and DOPAC levels were reduced. However, there was no significant difference of catecholamine metabolites among the three patient groups.The androgen status in polycystic ovary diagnosed by ultrasound is correlated, but catecholamine status is not correlated, with the menstrual irregularity of polycystic ovary syndrome.

The role of catecholamine activity in the GnRH-LH system among cases of polycystic ovary syndrome was investigated by high-performance liquid chromatography using an electrochemical detector. We measured plasma levels of catecholamine metabolites, 3-methoxy-4-hydroxyphenylglycol (MHPG) and 3,4-dihydroxyphenylacetic acid (DOPAC), in relation to LH-RH administration in 23 women with polycystic ovary syndrome. MHPG concentrations were significantly higher in polycystic ovary syndrome patients than in ten control subjects in early follicular phase. The peak values of LH after LH-RH administration were significantly correlated with plasma MHPG concentrations. These data suggest that an excess of norepinephrine is present in polycystic ovary syndrome and that the hypophyseal response to LH-RH administration is correlated with catecholamine, especially norepinephrine activity.

Polycystic ovary syndrome (PCOS) is characterized by chronic anovulation, elevated serum estrogen and androgen levels, and inappropriate gonadotropin secretion. The present study compares the androgen levels (free testosterone) and catecholamine metabolites (DOPAC as a marker of central dopaminergic activity, DOPEG as one of adrenergic activity) in patients with PCOS and normal controls. The mean serum LH and free testosterone levels of polycystic ovary patients were significantly higher than those of normal controls. The mean DOPEG/DOPAC ratio in the polycystic ovary patients was significantly higher than those of the control group and there was a significant correlation between free testosterone and DOPEG or the DOPEG/DOPAC ratio. It is suggested that, in vivo, norepinephrine excess is present in women with PCOS and that a hyperandrogenemic status is correlated with catecholamine activity.