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Hum. Reprod. Advance Access originally published online on May 9, 2006
Human Reproduction 2006 21(8):2189-2193; doi:10.1093/humrep/del136
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© The Author 2006. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Control of estradiol secretion in reproductive ageing

C.K. Welt1, Y. Jimenez, P.M. Sluss, P.C. Smith and J.E. Hall

Reproductive Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

1 To whom correspondence should be addressed at: Reproductive Endocrine, BHX 511, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA. E-mail: cwelt{at}partners.org

BACKGROUND: Estradiol (E2) concentration is preserved in older reproductive-aged women despite a decrease in follicle number and androstenedione (AD) levels. We hypothesized that increased aromatase activity accounts for E2 preservation in older women. METHODS: Older (36–46 years; n = 11) and younger (21–35 years; n = 10) women with 25- to 35-day menstrual cycles participated in a parallel design study. Daily blood samples were drawn starting at menses, and recombinant human FSH (rhFSH), 150 IU, was administered when the dominant follicle’s diameter was ≥16 mm. FSH, LH, E2, estrone (E1), AD and the AD/E1 ratio were compared. RESULTS: E2 and E1 concentrations and the E1/E2 ratio were similar across the follicular phase in older compared with younger women, whereas AD and the AD/E1 ratio were lower. Older women had higher FSH concentrations in the early follicular phase and fewer small follicles. RhFSH-stimulated changes in E1 were similar between older and younger subjects despite the smaller number of follicles. CONCLUSIONS: These findings suggest that E2 secretion is maintained by increased aromatase function in older compared with younger reproductive-aged women, whereas there is no apparent difference in 17beta-hydroxysteroid dehydrogenase activity. The increased aromatase is probably driven by increased FSH in the early follicular phase and compensates for the decreased follicle number in older reproductive-aged women.

Key words: androstenedione/aromatase/FSH/ovary


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