期刊
FERTILITY AND STERILITY
卷 94, 期 6, 页码 2228-2233出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.fertnstert.2009.12.081
关键词
Polycystic ovary syndrome; PCOS; follicular fluid; LC-MS/MS; mass spectrometry; steroid hormones; androgens; estrogens; CYP17; CYP19
资金
- Family Planning Fund, Uppsala, Sweden
- Swedish Research Council [629-2002-6821, 621-2005-5379]
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah
Objective: To compare steroid concentrations and steroid product-to-precursor ratios in ovarian follicular fluid (FF) from women with polycystic ovary syndrome (PCOS) and from regularly menstruating women in their early follicular phase, using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Polycystic ovary syndrome involves abnormal regulation of the steroidogenic enzymes, leading to arrest of follicle development. Design: Case-control study. Setting: University hospital clinic. Patient(s): Follicular fluid from size-matched ovarian follicles (5-8 mm) in 27 nonstimulated women with PCOS and in 21 women without PCOS was sampled. Thirteen steroids were quantitated from 40 mL of FF, using LC-MS/MS. Intervention(s): None. Main Outcome Measure(s): Concentrations of steroids in the FF and product-to-precursor ratios (enzyme activity) were compared between the groups. Result(s): In women with PCOS, ovarian FF contained higher concentrations of individual and total androgens, lower individual and total estrogens (E), and a lower total E-to-androgen ratio, compared with regularly menstruating women. The product-to-precursor concentration ratios indicated higher CYP17-linked and lower CYP19-linked (aromatase) enzyme activity. Receiver operating characteristic plots indicated the early CYP17 step (17-OH5P/5P) being highly important for the prevalence of PCOS (c = 0.95). Conclusion(s): The women with PCOS had higher ovarian CYP17-linked and lower CYP19-linked (aromatase) enzyme activity, confirming previous data. Multiple steroid assessments from minute volumes including FF from nonstimulated ovaries, using LC-MS/MS, might be useful in research, clinical endocrinology, and in IVF. (Fertil Steril (R) 2010;94:2228-33. (C) 2010 by American Society for Reproductive Medicine.)
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