OVARIAL FACTORS IN THE PATHOGENESIS OF CHRONIC ANOVULATION IN POLYCYSTIC OVARY SYNDROME
Keywords:polycystic ovary syndrome, anti-Mullerian hormone, apoptosis, hyperinsulinemia, insulin resistance
Background. Polycystic ovary syndrome (PCOS) involves defects in primary cellular control mechanisms that develop in the definition of chronic anovulation and hyperandrogenism. In PCOS the connection between the various parameters is of specific significance. One of major pathophysiologic hypotheses have been proposed to clarify the clinical data of PCOS related to the ovarian hypothesis. Aim of the study is to determine the serum concentration of the apoptosis inhibitor — soluble Fas (sFas) and to analyze the peculiarities of its content, depending on the clinical, metabolic and morphological features. Materials and methods. 68 women of reproductive age were divided into two groups. The main group consisted of 26 patients with PCOS, who had resection of the ovaries. The comparative group was formed by 22 patients undergoing surgical treatment, including resection or ovarian biopsy with regard to gynecologic pathology other than PCOS. The third (control) group — 20 healthy women. Results. In contrast to the control group, patients with PCOS have significantly higher level of anti-Mullerian hormone (AMH) in granulosus cells at all stages of folliculogenesis and there is no decrease in AMH level with the growth of antral follicles. Excessive income of AMH, possessing expressed influence inhibiting on the follicular apparatus is supposed, that can be cause of infringements folliculogenesis and ovulation. The increased level of sFas was evaluated in women with PCOS comparing to the control group. The maximum of sFas level was found in patients with PCOS and obesity and with insulin resistance regardless of body weight. Conclusion. Increased expression of sFas is the factor contributing persistence of atrophic follicles, activation of proliferative processes in women with PCOS.
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