Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, 100026, Beijing, People's Republic of China.
Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany.
J Ovarian Res. 2021 Feb 18;14(1):36. doi: 10.1186/s13048-021-00786-0.
To investigate abnormalities of early folliculogenesis and Anti-Müllerian hormone (AMH) concentrations in polycystic ovary syndrome (PCOS) patients, and to analyze the association between AMH and early-stage follicle densities (FD).
A total of 175 patients underwent ovarian tissue cryopreservation in the first official cryobank in China, of which 16 patients aged 30-40 years old were diagnosed with endometrial cancer (all without initial chemo/radiotherapy), including 5 patients with concurrent PCOS and the other 11 patients without. We obtained standard cortical biopsies to measure FD using calcein staining. Blood samples were collected before cryopreservation to evaluate AMH concentrations.
PCOS showed nearly three times the primordial and primary FD than NPCOS (P = 0.027), as well as more secondary preantral follicles (P = 0.002). A significantly higher proportion of secondary preantral follicles and a lower proportion of primordial and primary follicles were observed in PCOS (P = 0.01). Furthermore, the AMH concentration in PCOS was four times higher than that in NPCOS (P = 0.003), which is significantly correlated with primordial and primary follicle densities (r = 0.855, P < 0.001) and secondary preantral follicle densities (r = 0.732, P = 0.007).
We found significant disorders of early folliculogenesis in PCOS, which showed close correlation with increased AMH concentrations. To our knowledge, abnormalities of early-stage follicles have been shown for the first time in ovarian tissue of Chinese PCOS women. We suppose that the elevated AMH level is associated with abnormalities of early folliculogenesis within the complex PCOS pathogenesis, which may explain why AMH has the potential to be used as a biomarker for the diagnosis of PCOS. Our findings provide more implications for understanding the mechanism of PCOS, and new directions for further studies.
研究多囊卵巢综合征（PCOS）患者早期卵泡发生异常和抗苗勒管激素（AMH）浓度，并分析 AMH 与早期卵泡密度（FD）之间的关系。
在中国首家官方冻卵库中，共有 175 名患者接受了卵巢组织冷冻保存，其中 16 名年龄在 30-40 岁的患者被诊断为子宫内膜癌（均未接受初始化疗/放疗），包括 5 名并发 PCOS 的患者和 11 名无 PCOS 的患者。我们获得标准皮质活检标本，使用钙黄绿素染色测量 FD。在冷冻保存前采集血样以评估 AMH 浓度。
PCOS 的原始和初级 FD 几乎是 NPCOS 的三倍（P = 0.027），同时具有更多的次级窦前卵泡（P = 0.002）。PCOS 患者中次级窦前卵泡的比例明显更高，原始和初级卵泡的比例明显更低（P = 0.01）。此外，PCOS 患者的 AMH 浓度是 NPCOS 的四倍（P = 0.003），与原始和初级卵泡密度（r = 0.855，P < 0.001）和次级窦前卵泡密度（r = 0.732，P = 0.007）显著相关。
我们发现 PCOS 存在明显的早期卵泡发生异常，与 AMH 浓度升高密切相关。据我们所知，这是首次在中国 PCOS 女性的卵巢组织中发现早期卵泡异常。我们假设，升高的 AMH 水平与 PCOS 发病机制中的早期卵泡发生异常有关，这可能解释了为什么 AMH 有潜力作为 PCOS 诊断的生物标志物。我们的研究结果为深入了解 PCOS 的发病机制提供了更多的启示，并为进一步的研究提供了新的方向。
