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Hum. Reprod. Advance Access published online on May 9, 2006
Human Reproduction, 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
Received December 4, 2005
Revised March 7, 2006
Accepted April 4, 2006

Article

Control of estradiol secretion in reproductive ageing

C.K. Welt 1 *, Y. Jimenez 1, P.M. Sluss 1, P.C. Smith 1, and J.E. Hall 1

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

* To whom correspondence should be addressed.
C.K. Welt, E-mail: cwelt{at}partners.org


  Abstract

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 17{beta}-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.

Keywords: androstenedione/aromatase/FSH/ovary.
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