Serum GDF9 and BMP15 as potential markers of ovarian function in women with and without polycystic ovary syndrome

ObjectiveGrowth differentiation factor-9 (GDF9) and bone morphogenetic protein-15 (BMP15) are critical paracrine regulators of female fertility and are predominantly expressed by oocytes. However, it is unknown if serum concentrations reflect changes in ovarian function and/or reproductive endocrine disorders. This study aimed to determine if serum GDF9/BMP15 are associated with ovarian, pituitary, oestrogenic, androgenic and metabolic characteristics and the ovarian pathologies, polycystic ovarian morphology (PCOM) and polycystic ovary syndrome (PCOS). DesignWomen aged 21-45 years (n = 381) were included from a cross-sectional study at the National University Hospital, Singapore. Patients: Participants were volunteers and patients with possible PCOS. Measurements: Anthropometric measurements, transvaginal ultrasound scans and serum sampling were performed and a questionnairecompleted. Serum GDF9 and BMP15 concentrations were matched with menstrual cycle length, ovarian protein and steroid hormone production, pituitary hormone production and metabolic assessments in women with PCOM or PCOS and those with neither (control). ResultsSerum GDF9 and BMP15 were detectable in 40% and 41% of women, respectively and were positively correlated with each other (r = 0.08, p = 0.003). GDF9, but not BMP15, was positively correlated with ovarian volume (p = 0.02) and antral follicle count (AFC) (p = 0.004), but not with anti-Mullerian hormone (p = 0.05). However, serum GDF9 and BMP15 concentrations were not significantly different between control, PCOM and PCOS women, nor associated with androgenic or metabolic PCOS features. However, the relationship between GDF9 and AFC differed between control, PCOM and PCOS women (p = 0.02). ConclusionsSerum GDF9 and BMP15 concentrations somewhat reflect ovarian but not androgenic or metabolic characteristics of PCOS, with increased GDF9 reflecting high AFC as seen in PCOM/PCOS.

Automated summary

This study aimed to determine if serum GDF9/BMP15 are associated with ovarian, pituitary, estrogenic, androgenic, and metabolic characteristics and ovarian pathologies. The results showed that serum GDF9 and BMP15 concentrations were detectable in 40% and 41% of women, respectively, and were positively correlated with each other. However, serum GDF9 and BMP15 concentrations were not significantly different between control, PCOM, and PCOS women, nor associated with androgenic or metabolic PCOS features.