Department of Nutritional Sciences, Cornell University, College of Agriculture and Life Sciences, Ithaca, NY 14853, USA.
Ultrasound Obstet Gynecol. 2010 Dec;36(6):759-66. doi: 10.1002/uog.7751. Epub 2010 Jul 19.
To determine if amenorrheic women with polycystic ovary syndrome (PCOS) demonstrate ultrasonographically detectable changes in follicle population.
Sixteen women with PCOS reporting the absence of menses for more than 3 months were enrolled in the study. Subjects had a physical examination, fasting blood tests and two transvaginal ultrasound scans spaced 1 month apart. In cases where evidence of a morphologically dominant follicle (≥ 10 mm in diameter) occurred, subsequent ultrasound scans were performed to determine the fate of the dominant follicle. Differences in total follicle population, maximum follicle diameter and clinical, hormonal and metabolic features were determined.
Forty-four percent of subjects showed changes in follicle population of 6-10 follicles and 37% showed changes in follicle population of > 10. Maximum follicle diameters ranged between 5.4 and 33.0 mm. Four subjects demonstrated follicle diameters ≥ 10 mm. Of those who developed dominant follicles, two subjects ovulated, one subject developed a persistent anovulatory follicle and the dominant follicle regressed in the remaining subject. Diagnostic criteria for PCOS were similar among women that did or did not develop dominant follicles (menstrual cycle length, P = 0.880; hirsutism score, P = 0.809; free androgen index, P = 0.991; total follicle count, P = 0.199). However, lower glycosylated hemoglobin (P = 0.047) and insulin levels (P = 0.049) and better insulin sensitivity (P = 0.048) were noted in women who attained dominant follicles.
Amenorrheic women with PCOS demonstrate changes in follicle population that are consistent with active follicle growth and regression despite prolonged periods of anovulation. Morphologic selection occurs in amenorrheic women and attainment of dominant follicles is associated with improved metabolic status.
确定患有多囊卵巢综合征（PCOS）的闭经妇女是否表现出卵泡数量的超声可检测变化。
研究纳入了 16 名闭经超过 3 个月且报告无月经的 PCOS 患者。受试者接受了体格检查、空腹血液检查和两次相隔 1 个月的经阴道超声扫描。如果出现形态上的优势卵泡（≥ 10 毫米直径），则进行后续超声扫描以确定优势卵泡的命运。比较总卵泡数量、最大卵泡直径以及临床、激素和代谢特征。
44%的受试者卵泡数量增加了 6-10 个卵泡，37%的受试者卵泡数量增加了>10 个。最大卵泡直径范围在 5.4 到 33.0 毫米之间。4 名受试者的卵泡直径≥10 毫米。在发展为优势卵泡的受试者中，有 2 名排卵，1 名发生持续无排卵卵泡，而优势卵泡在其余受试者中退化。是否发生优势卵泡的 PCOS 诊断标准相似（月经周期长度，P=0.880；多毛症评分，P=0.809；游离雄激素指数，P=0.991；总卵泡计数，P=0.199）。然而，在获得优势卵泡的女性中，糖化血红蛋白（P=0.047）和胰岛素水平（P=0.049）较低，胰岛素敏感性（P=0.048）较好。
尽管长时间无排卵，患有 PCOS 的闭经妇女的卵泡数量仍发生变化，表明存在活跃的卵泡生长和退化。形态学选择发生在闭经妇女中，获得优势卵泡与改善的代谢状态相关。
