Abstract (EN):
Polycystic ovarian syndrome (PCOS) is characterised by oligo/amenorrhea and hyperandrogenism, being the most common cause of anovulatory infertility. Inhibin B is produced by small antral follicles, while inhibin A is secreted by the mature dominant follicle and corpus luteum. Aims: To compare inhibin serum levels in patients with polycystic ovarian syndrome and control group; to assess hormonal profile and gynaecological ultrasound in patients with polycystic ovarian disease before and after laparoscopic ovarian drilling. Design: The concentrations of inhibin A and B, FSH, LH, prolactin, estradiol, ¿4 androstenedione, 17OH-progesterone, testosterone, DHEAS, insulin e IGF-1 were measured in 18 women with PCOS between the 5-7th day of the cycle and the concentrations of inhibin A, inhibin B and progesterone between the 21-23th day; gynaecological ultrasound was performed between the 5-7th day of the cycle, with measurement of ovarian volume, number of follicles at a diameter of less than 8 mm, follicle/stromal relationship and endometrial thickness. The control population was 18 health, voluntary and caucasians women at fertile age that did not make any medication. Laparoscopic ovarian drilling was performed in 11 (of the 18) PCOS women, the same hormonal measurements and gynaecological ultrasound were repeated about 3 month after that. Results: At the fifth day of the cycle we have found concentration of inhibin B significantly higher in PCOS than in control women. The levels of inhibin B at 5th day of the cycle had a significant correlation with the number of ovarian follicles and with LH levels. All operate women had natural menses about thirty days after the operation. There was a significant reduction (p<0.05) of the testosterone levels and of the number of ovarian follicles (p<0.05) after the surgery. We had also observed a significant reduction of the inhibin B concentrations at the 5th and 21st day of the cycle. There were no significant differences in the concentrations of inhibin A before and after laparoscopy. One woman has been pregnant. Conclusions: The inhibin B levels are elevated at the second phase of the cycle of PCOS patients and those levels of the 5th day of the cycle appear to be an indication of the degree of ovarian hyperstimulation. The laparoscopic ovarian diathermy reduces the levels of testosterone, inhibin B and the number of ovarian follicles, with hormonal normalisation of the PCOS women. We have realised just a relative fertility improvement.
Idioma:
Português
Tipo (Avaliação Docente):
Científica