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The impact of polycystic ovary syndrome and body mass index on the absorption of recombinant human follicle stimulating hormone

Abstract

Purpose

Women with polycystic ovary syndrome (PCOS) have an increased ovarian responsiveness to exogenous recombinant follicle stimulating hormone (rFSH) but also have high rates of obesity, which is known to affect serum FSH concentrations following exogenous injection. The purpose of this study was to compare rFSH absorption and ovarian response between lean and overweight/obese PCOS subjects and normo-ovulatory controls.

Methods

Fourteen women with PCOS aged 18–42 years old with a BMI of 18.5–24.9 kg/m2 (normal) or 25.0–40.0 kg/m2 (overweight/obese) and eleven normo-ovulatory controls matched by age and BMI were included. After downregulation with oral contraceptives, participants were administered a single subcutaneous injection of 225 IU rFSH and underwent serial blood draws over 72 h.

Results

Lean PCOS subjects exhibited a significantly higher area under the curve (AUC) of baseline-corrected serum FSH over 72 h when compared with overweight/obese PCOS subjects (183.3 vs 139.8 IU*h/L, p = 0.0002), and lean, normo-ovulatory women had a significantly higher AUC FSH when compared with overweight/obese, normo-ovulatory women (193.3 vs 93.8 IU*h/L, p < 0.0001). Within overweight/obese subjects, those with PCOS had a significantly higher AUC FSH compared with normo-ovulatory controls (p = 0.0002). Lean PCOS subjects similarly had the highest AUC of baseline-corrected estradiol (6095 pg h/mL), compared with lean normo-ovulatory subjects (1931 pg h/mL, p < 0.0001) and overweight/obese PCOS subjects (2337 pg h/mL, p < 0.0001).

Conclusion

Lean PCOS subjects exhibited significantly higher baseline-corrected FSH and estradiol levels following rFSH injection compared with overweight/obese PCOS subjects with similar ovarian reserve markers. Amongst overweight/obese subjects, those with PCOS had significantly higher FSH and E2 levels when compared with normo-ovulatory controls.

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Acknowledgments

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources, the National Center for Advancing Translational Science, or the National Institutes of Health.

Funding

This work was conducted with support from the Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Expanding the Boundaries Grant; EMD Serono; and Harvard Catalyst, The Harvard Clinical and Translational Science Center (the project was supported by Grant Number 1UL1TR002541-01, Harvard Clinical and Translational Science Center, from the National Center for Advancing Translational Science and Grant Number 1UL1TR001102). Research reported in this publication was supported in part by the Office of the Director, National Institutes of Health under Award Number P51OD011106 to the Wisconsin National Primate Research Center, University of Wisconsin-Madison.

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Correspondence to Malinda S. Lee.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (Partners Healthcare Institutional Review Board) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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MSL, AL, AVD, AB have nothing to disclose. ESG receives royalties from UpToDate.

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Cite this article

Lee, M.S., Lanes, A., Dolinko, A.V. et al. The impact of polycystic ovary syndrome and body mass index on the absorption of recombinant human follicle stimulating hormone. J Assist Reprod Genet 37, 2293–2304 (2020). https://doi.org/10.1007/s10815-020-01865-9

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Keywords

  • Polycystic ovary syndrome
  • Pharmacokinetics
  • Pharmacodynamics
  • Body mass index
  • Obesity
  • Follicle stimulating hormone