控制性超促排卵对黄体期子宫内膜胶原纤维表达的影响

目的:探讨IVF-ET妇女控制性超促排卵(COH)时着床窗期子宫内膜胶原纤维(collagen fibril,CF)对子宫内膜容受性(ER)的影响。方法:共对25个刺激周期(SC)和20个自然周期(NC)妇女分别在取卵后或排卵后的第7±1日行外周血雌、孕激素水平检测和子宫内膜活检术,常规HE染色确定组织学分期,采用透射电子显微镜观察CF增生情况和改良Masson染色进行CF定量分析。结果:SC组外周血雌、孕激素水平均显著高于NC组(P<0.05)。SC组分泌期较NC组提前1～2 d,内膜腺体扩张和间质水肿明显。SC组分泌早、中和晚期内膜间质中的CF较NC组显著升高(P<0.01,P<0.05和P<0.05),且SC组分泌早期SC明显高于分泌中期(P<0.05)。结论:COH过程中过高的雌、孕激素水平可使子宫内膜分泌期提前并刺激内膜CF的过度增生,这可能是导致COH周期ER下降和着床失败的原因。     

子宫内膜癌γ-synuclein表达和血清CA125水平及与临床病理特征关系的研究

目的:研究乳腺癌基因1(γ-synuclein)表达和血清癌抗原125(CA125)水平及与子宫内膜癌临床病理特征的关系,探讨其在子宫内膜癌发生发展中的作用及对病情评估的意义。方法:采用免疫组化SP法检测50例子宫内膜样腺癌(子宫内膜癌组)、14例子宫内膜不典型增生(子宫内膜不典型增生组)、12例正常子宫内膜(对照组)组织中γ-synuclein的表达,用化学发光免疫分析法检测患者血清CA125的水平。结果:γ-synuclein阳性表达在子宫内膜癌组、子宫内膜不典型增生组及对照组间比较,差异有高度统计学意义(χ2=10.379,P<0.01),其中,γ-synuclein在子宫内膜癌组及子宫内膜不典型增生组中的阳性表达均显著高于对照组(P均<0.01)。在子宫内膜癌组γ-synuclein表达与临床分期、肌层浸润深度有关(P<0.05,P<0.01)。子宫内膜癌组血清CA125水平阳性率显著高于对照组及子宫内膜不典型增生组(χ2=7.040,P<0.01)。γ-sy-nuclein、血清CA125之间无相关性(r=0.201,P>0.05)。结论:γ-synuclein的表达与子宫内膜癌发生发展及侵袭有关,可能作为预后指标;血清CA125水平可能预示子宫内膜癌的恶性程度。     

瘦素及瘦素长受体在多囊卵巢综合征患者子宫内膜的表达

目的　探讨瘦素 (leptin)和瘦素长受体 (Ob RL)mRNA及蛋白在多囊卵巢综合征(PCOS)患者着床期子宫内膜的表达及意义。方法　应用免疫组织化学技术及原位杂交技术 ,分别对15例正常妇女 (对照组 )、14例无排卵PCOS患者 (PCOS组 )促排卵治疗后着床期子宫内膜的leptin、Ob RL mRNA及蛋白进行测定。结果　对照组中 ,子宫内膜 10例呈分泌期中期改变 ,5例呈分泌期早期改变。PCOS组中 ,子宫内膜 3例呈分泌期中期改变 ,6例呈分泌期早期改变 ,1例呈增殖期改变 ,4例呈增殖期并分泌期早期改变 ;子宫内膜发育不良发生率 79% (11/ 14 ) ,与对照组比较 ,差异有显著性 (P <0 .0 5 )。Ob RL mRNA和蛋白在PCOS患者子宫内膜腺体呈阴性到强阳性表达 ,但多呈弱阳性和阳性表达 ,对照组则呈弱阳性到强阳性表达 ,两组比较 ,差异有显著性 (P <0 .0 5 ) ;leptinmRNA和蛋白在PCOS患者子宫内膜的表达与对照组相似 ,两组比较 ,差异无显著性 (P >0 .0 5 )。结论　促排卵周期中 ,Ob RL 在PCOS患者着床期子宫内膜腺体表达减弱 ,可能与PCOS患者妊娠率低有关     

输卵管积水对着床窗期子宫内膜人白血病抑制因子(LIF)和转化生长因子(TGF-β_2)表达的影响

目的:探讨输卵管积水对人子宫内膜着床窗期的影响。方法:用免疫组化法检测输卵管积水组(A组)、输卵管阻塞无积水组(B组)和正常组(C组)着床窗期子宫内膜人白血病抑制因子(LIF)和转化生长因子(TGF)-β2的表达。结果:LIF和TGF-β2在3组着床窗期子宫内膜都有表达,A组的LIF和TGF-β2表达均明显低于B组和C组组(P<0.05)。结论:输卵管积水妇女着床窗期子宫内膜LIF和TGF-β2的低表达可能是输卵管积水妇女胚胎种植失败的原因之一。     

白细胞抑制因子(LIF)对离体小鼠子宫内膜岩藻糖基转移酶(FuT7)表达的影响

目的:探讨白血病抑制因子(LIF)对小鼠子宫内膜细胞岩藻糖基转移酶(FuT7)因子表达的影响。方法:分别用含LIF和抗LIF-抗体(LIF-Ab)培养液孵育子宫内膜细胞10h,通过PCR、免疫荧光和免疫印迹方法分析各组培养液中FuT7因子的表达。结果:PCR结果显示:与空白对照组比,LIF对离体子宫内膜细胞FuT7基因表达有上调作用(0.26±0.02vs0.18±0.01),而LIF-Ab可抑制子宫内膜细胞FuT7的表达(0.14±0.04vs0.18±0.01)。免疫荧光和免疫印迹结果同样显示经LIF孵育后,子宫内膜细胞FuT7蛋白量有所增加。结论:LIF在体外可调控子宫内膜细胞FuT7表达,并有可能借此来调控着床阶段特异表达的sLeX寡糖抗原量,继而影响整个着床调控网络。     

来曲唑和克罗米酚对小鼠着床期子宫内膜容受性的影响

目的:探讨来曲唑和克罗米酚对小鼠着床期胞饮泡和白血病抑制因子(LIF)表达的影响。方法:将30只小鼠随机分为3组:来曲唑(LE)组(n=10)、克罗米酚(CC)组(n=10)及对照组(n=10)。促排卵后妊娠d4．5取小鼠子宫,采用扫描电镜观察3组子宫内膜胞饮突的变化以及免疫组化技术检测子宫内膜LIF的表达强弱。结果:在3组妊娠天数一致的情况下,LE组中无论是子宫内膜胞饮突,还是LIF的表达,均与对照组相似。而CC组的表达显著弱于前二组。结论:与CC促排卵相比,LE不影响小鼠着床期子宫内膜超微结构和相关基因LIF的表达,然而CC组子宫的容受性呈现一定的抑制性。     

多囊卵巢综合征无排卵患者子宫内膜超声形态学及组织学变化

目的探讨多囊卵巢综合征(PCOS)无排卵患者子宫内膜超声形态学的变化特点,及组织学变化与激素水平的关系。方法采用B超观察76例PCOS无排卵患者(PCOS组)及32例排卵正常的不孕患者(对照组)的子宫内膜;按照Gonen等的分型方法,将子宫内膜分为A型(即低回声三线型)、B型(即均质中等回声)、C型(即强回声)3型;采用免疫组化技术,检测子宫内膜腺上皮细胞增殖相关核抗原Ki67及降钙素的表达;采用透射电镜观察子宫内膜超微结构;采用酶联免疫发光法,检测血清中黄体生成激素及孕酮等的水平。结果PCOS组子宫内膜为A型者23例,B型者34例、C型者17例,另2例患者因内膜厚度<5mm,未进行分型。A型患者的内膜间质发育异常比率为9%(2/23),B型和C型为43%(22/51)两者比较,差异有统计学意义(P<0·05)。PCOS组分泌期内膜腺上皮细胞Ki67表达为(14±6)%,对照组为(9±7)%,两组比较,差异有统计学意义(P<0·05)。PCOS组增生期子宫内膜腺上皮细胞中细胞器增多;分泌期显示分泌反应不良。结论PCOS无排卵患者子宫内膜呈现增生和分泌表现异常,其内膜超声形态学的强回声表现,可能与局灶性内膜间质发生异常组织学改变有关。     

Meis1在子宫内膜异位症不孕患者子宫内膜中的表达研究

目的:初步探索HOXA10的辅因子(Meis1)与子宫内膜异位症(EMs)患者不孕和发病的相关性。方法:采用免疫组织化学方法进行组织学定位并进行半定量分析,采用Westernblot-ting方法在蛋白水平上进行定量分析,检测EMs不孕患者异位和在位子宫内膜中Meis1的表达水平。结果:免疫组织化学结果显示,Meis1在异位内膜和在位内膜中仅有弱表达,而在正常同期内膜中呈较明显的阳性表达,差异显著(P<0.01);比较Meis1在分泌中期在位内膜与正常内膜中的表达,差异亦有显著性(P<0.01)。Westernblotting显示,Meis1在分泌中期在位内膜中仅有弱表达,而在同期正常内膜中呈高表达(P<0.001)。结论:Meis1在EMs患者分泌中期在位内膜中低表达,可能是影响子宫内膜容受性的建立,从而影响胚胎着床导致不孕的重要因素之一。同时,Meis1在异位内膜中的低表达说明异位内膜可能对体内雌、孕激素正常调控具有抵抗性,异位内膜细胞具备了对抗凋亡的能力,提示Meis1可能参与了EMs的发生与发展。     

多囊卵巢综合征患者子宫内膜mPGES-1和COX-2表达的研究

目的:探讨多囊卵巢综合征(PCOS)患者膜结合型前列腺素合酶-1(mPGES-1)和环氧合酶-2(COX-2)在子宫内膜组织的表达及临床意义。方法:选择2005年6月至2007年6月华北煤炭医学院生殖内分泌门诊诊断为PCOS的患者21例为PCOS组,卵巢功能正常的不孕患者20例为对照组。PCOS组采用二甲双胍/达英-35联合治疗。病例均测体重、身高、性激素六项及75g葡萄糖耐量试验(OGTT)和胰岛素释放试验(IRT)。并于月经干净3～5天(闭经患者确认为卵泡期)取子宫内膜组织,采用免疫组织化学技术检测PCOS组治疗前后及对照组中mPGES-1和COX-2的表达。结果:PCOS组患者BMI、HOMA-IR、空腹胰岛素(I0)、75g葡萄糖负荷后2h胰岛素(I120)及T均明显高于对照组患者(P均<0.05);治疗前PCOS组mPGES-1和COX-2在子宫内膜的表达显著高于对照组(P<0.01),治疗后两因子的表达与治疗前比较明显下降(P<0.01)。结论:PCOS患者子宫内膜可能处于一种慢性炎症状态,子宫内膜mPGES-1和COX-2过度表达可能是导致患者子宫内膜异常增生和不孕的原因之一,二甲双胍/达英-35联合应用可逆转该炎症状态,可能有利于孕卵着床和预防子宫内膜癌发生。     

白血病抑制因子在子宫内膜异位症并发不孕患者黄体中期子宫内膜中的表达

目的:探讨白血病抑制因子(LIF)在子宫内膜异位症(EM)导致不孕机制中的作用。方法:采用原位杂交及免疫组织化学方法对15例异位症并发不孕患者黄体中期子宫内膜中的LIF mRNA及其蛋白的表达进行定位及半定量分析,并以15例有生育妇女作为对照组。结果:子宫内膜异位症组LIF mRNA平均光密度为3.12±0.32,LIF蛋白平均光密度为9.31± 2.10,显著低于对照组的6.25±2.14与15.70±1.52(P<0.05)。结论:子宫内膜异位症组黄体中期子宫内膜LIF表达下降可能是其不孕的原因之一。     

多囊卵巢综合征患者卵泡液LIF、IL-1β及性激素水平与IVF-ET结局关系的研究

目的:探讨多囊卵巢综合征(PCOS)患者卵泡液中白血病抑制因子(LIF)、白细胞介素-1β(IL-1β)及性激素水平与IVF-ET结局的关系。方法:用酶联免疫双抗夹心法和时间分辨免疫荧光法前瞻性研究了行IVF-ET的11例PCOS患者、14例对照组患者卵泡液中IL-1β、LIF及雌二醇(E2)和孕酮(P)的定量表达。结果:PCOS组卵泡液中LIF为21.1±11.1pg/mL,P为191.9×103nmol/L,明显低于对照组(33.5±11.8pg/mL,305.9×103nmol/L,P<0.05);而PCOS组卵泡液IL-Iβ为39.9±11.5pg/mL,E2浓度为3334.00nmol/L,明显高于对照组(28.3±10.6pg/mL,2138.1nmol/L),P<0.05。PCOS组胚胎种植率为8.8%,临床妊娠率为18.2%,明显低于对照组(16.7%,42.9%),P<0.05;PCOS组OHSS发生率为27.3%,明显高于对照组(7.1%,P<0.05)。LIF与E2在两组患者呈负相关(r=-0.442,P=0.027)、LIF与LH/FSH比值在PCOS组呈负相关(r=-0.682,P=0.021);IL-Iβ与E2在PCOS组呈正相关(r=0.612,P=0.045);LH/FSH比值与P在PCOS组呈负相关(r=-0.780,P=0.005);LIF与IL-Iβ水平两者间无明显相关性。结论:LIF可能是PCOS患者低种植率的关键因子;IL-Iβ可能是PCOS患者在控制性超排卵过程中易发生OHSS的一个致病因子;卵泡液IL-Iβ、LIF受卵巢激素调控。     

卵巢黄素化颗粒细胞瘦素信号转导分子STAT3磷酸化在多囊卵巢综合征发病中的作用

目的:探讨瘦素在多囊卵巢综合征(PCOS)发病中的作用。方法:选择行IVF-ET治疗的30例PCOS患者根据体重指数(BMI)分为肥胖者(BMI≥24)15例和非肥胖者(BMI<24)15例,及同期排卵功能正常或单纯输卵管因素不孕的非PCOS肥胖者和非肥胖者各15例,采用ELISA检测各组血清瘦素水平;采用放射免疫法检测各组空腹血清胰岛素(FIN)水平;采用葡萄糖氧化酶法测定各组空腹血糖(FPG)水平,利用稳态模型(HOMA)计算胰岛素抵抗指数(即HOMA-IR);采用Western blotting检测卵巢黄素化颗粒细胞信号转导分子STAT3磷酸化水平;同法检测不同浓度的瘦素(0ng/ml、10ng/ml、100ng/ml、1000ng/ml)体外对正常人卵巢黄素化颗粒细胞STAT3磷酸化(p-STAT3)的影响。结果:①血清瘦素水平PCOS肥胖者最高,其后依次为对照组肥胖者、PCOS非肥胖者和对照组非肥胖者,各组之间两两比较,差异均具有显著性(P<0.05);②PCOS患者血清瘦素水平与BMI和HOMA-IR均呈显著正相关(r=0.707,P<0.01;r=0.761,P<0.01);③STAT3水平肥胖PCOS组最高,其后依次为肥胖对照组、非肥胖PCOS组和正常对照组,各组间两两比较,差异均具有显著性(P<0.05);④正常人卵巢黄素化颗粒细胞经不同浓度瘦素处理48h后,p-STAT3水平呈不同程度增加,至瘦素浓度达到100ng/ml时,p-STAT3水平达到高峰,随后呈下降趋势。结论:瘦素可能通过激活JAK2/STAT3信号传导通路参与PCOS排卵障碍的发生。     

Hyperinsulinemia does not influence androgens/estrogens ratio in patients with polycystic ovarian syndrome

OBJECTIVE: The ratio of androgens to estrogens in patients with polycystic ovarian syndrome (PCOS) and controls was evaluated in order to investigate whether hyperinsulinemia might induce hyperandrogenemia by decreasing androgen catabolism. STUDY DESIGN: Forty women were divided into four groups according to the presence of PCOS, insulin resistance, and normal or abnormal body mass index (BMI); each group consisted of 10 women. Group I comprised patients with PCOS, insulin resistance, and abnormal BMI. Group II consisted of patients with PCOS, without insulin resistance, and with normal BMI. Group III consisted of healthy women (controls) with abnormal BMI. Group IV consisted of healthy women with normal BMI. RESULTS: We found that: (1) the mean fasting insulin levels of groups II, III, and IV were significantly lower than those of group I (P < .001); (2) serum testosterone levels were significantly lower in groups III and IV than in group I and II; (3) there were no significant differences in serum estradiol and estrone levels between women of all groups; (4) women of groups III and IV had significantly lower ratios of testosterone to estradiol at time 0 compared to patients of groups I and II. CONCLUSION: Our results support the view that since hyperinsulinemia induces hyperandrogenism, the increase of androgens should not be attributed to the decrease of androgen catabolism.     

Oocyte and embryo quality in polycystic ovary syndrome

OBJECTIVE: To compare oocyte and embryo quality in women with Polycystic Ovary Syndrome (PCOS) and in women with normal ovulation. PATIENTS AND METHODS: Forty women with PCOS underwent a total of 67 In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) cycles. The control group consisted of women, of the same age, who underwent IVF (for tubal infertility) or ICSI (for male factor infertility) in the same period. RESULTS: The average number of oocytes recovered was higher in the PCOS group (12,1) than in the control group (9.6) as was the rate of immature oocytes (13.8% vs 5.8%; respectively). The fertilization rate was lower in PCOS patients (52% vs 61% in the controls). The cleavage rates, embryo morphology and pregnancy rates were similar in both groups. DISCUSSION AND CONCLUSIONS: Although more oocytes were recovered from PCOS patients, the number of good quality embryos, suitable for transfer or freezing was similar in the two groups as less of the oocytes were mature and the fertilization rate was lower in the PCOS group. IVF or ICSI (according to the indication) are therefore efficient in PCOS patients.     

Prevalence of polycystic ovary syndrome in unselected women from southern China

OBJECTIVE: The objective was to determine the prevalence and metabolic parameters of polycystic ovary syndrome (PCOS) in southern China. STUDY DESIGN: The study was observational with a parallel study. Participants were studied in a medical examination center. A population of 915 women of reproductive age was investigated at the time of their annual physical examination to determine the prevalence of PCOS in unselected women from southern China. RESULTS: Our results demonstrated a 2.2% (20/915) prevalence of PCOS. Women with PCOS had higher levels of luteinizing hormone and higher luteinizing hormone/follicle-stimulating hormone ratios than those in the other groups. Women with PCOS had higher fasting insulin levels and lower fasting glucose/fasting insulin ratios than women in any of the other groups. CONCLUSIONS: Some clinical and biochemical characteristics were apparent in PCOS patients in our population, and ethnic differences may be considered when studying the clinical and metabolic features of PCOS in China.     

Are polycystic ovaries associated with cardiovascular disease risk as polycystic ovary syndrome?

AIM: Our aim was to assess C-reactive protein (CRP) levels and insulin resistance in women with polycystic ovary syndrome (PCOS) or polycystic ovaries (PCO). METHODS: The study population included 30 women with PCOS, 30 with PCO and 30 healthy controls. CRP and insulin resistance index (IRI) (fasting glucose/insulin) were measured. A receiver-operator characteristic (ROC) curve was constructed to determine the cut-off value of CRP to predict increased cardiovascular risk. RESULTS: There were no statistically significant differences between the three groups with regard to age and body mass index. IRI was significantly lower in the PCOS group than in the PCO and control groups. No difference existed between the PCO and control groups. Median CRP levels in the control, PCO and PCOS groups were 0.75, 1.3 and 1.5 mg/l, respectively (p = 0.005). CRP could differentiate between women with and without increased cardiovascular risk at a cut-off value of 2.42 mg/l, with a sensitivity of 79% and a specificity of 81%. CONCLUSION: As in PCOS patients, women with PCO have higher serum CRP levels than healthy control women. This may contribute to increased cardiovascular disease risk in patients with PCO.     

Polycystic ovarian syndrome (PCOS) and insulin resistance.

OBJECTIVES: Polycystic ovary syndrome (PCOS) presents a high risk of developing type 2 diabetes mellitus. We studied a group of women with PCOS and evaluated this defect in insulin action. METHODS: The study population consisted of nine PCOS women, six obese type 2 diabetic patients, and five controls whose body mass index (BMI) was similar to that of the nine PCOS women. The 75-g oral glucose tolerance test (OGTT) and the hyperinsulinemic euglycemic glucose clamp test were performed. Clinical characteristics and the metabolic profiles, including the insulin sensitivity index (ISI), were compared. RESULTS: PCOS women showed significantly elevated insulin responses during OGTT, but their blood glucose levels were comparable with the controls. The subjects with PCOS had more insulin resistance than the other groups. There was no difference among the groups in terms of clinical characteristics and metabolic profiles, except age, luteinzing hormone (LH), testosterone, and sex hormone binding globulin (SHBG). CONCLUSION: We conclude that PCOS women have significant insulin resistance which is independent of adiposity.     

Comparison of fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome and women with simple obesity.

The present study aimed to assess the fibrinolytic and metabolic system parameters in obese patients with polycystic ovary syndrome (PCOS) and to compare them in obese PCOS patients and women with simple obesity. We studied 19 obese women with PCOS (age: 25.1 +/- 4.6 years, body mass index (BMI): 34.7 +/- 3.9 kg/m2; mean +/- standard deviation) and 20 age- and BMI-matched ovulatory controls. We measured blood levels of 17beta-estradiol, testosterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH), dehydroepiandrosterone sulfate (DHEAS), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glucose and insulin. The following fibrinolytic tests were also performed: euglobulin clot lysis time, plasminogen level, alpha2-antiplasmin activity, plasminogen activator inhibitor-1 activity, fibrinogen concentration and estimated fibrinolytic activity. Testosterone and LH levels were significantly higher in obese women with PCOS (p < 0.01 and p < 0.001, respectively). The groups did not differ with regard to 17beta-estradiol, prolactin, FSH, DHEAS, TC, TG, HDL-C, LDL-C, glucose and insulin. All of the fibrinolysis parameters with the exception of plasminogen were comparable between the two groups. Serum plasminogen level was lower in obese PCOS patients than in women with simple obesity (p < 0.05). Euglobulin clot lysis time was positively correlated with insulin (r = 0.88, p < 0.05) in both groups. Our results show that fibrinolysis is not suppressed in women with PCOS and that there is no difference in fibrinolytic activity between obese patients with PCOS and women with simple obesity.     

抗苗勒管激素与非肥胖型多囊卵巢综合征合并胰岛素抵抗的关系

目的:探究抗苗勒管激素(AMH)与非肥胖型多囊卵巢综合征(PCOS)合并胰岛素抵抗(IR)的关系。方法:研究纳入102例非肥胖型PCOS患者为PCOS组,其中PCOS合并IR组(n=48),单纯PCOS组(n=54),50名非肥胖型健康人作为对照组。比较3组血清AMH水平以及AMH水平与PCOS合并IR的关系。结果:PCOS合并IR组血清AMH水平和HOMA-IR高于单纯PCOS组和对照组,差异有统计学意义(均P0.001)。PCOS组AMH水平与HOMAIR呈正相关(r=0.704,P0.001)。结论:非肥胖型PCOS患者合并IR血清AMH水平升高,AMH水平与PCOS合并IR相关。     

Does ovarian blood flow distinguish between ovulatory and anovulatory patients with polycystic ovary syndrome?

OBJECTIVE: The purpose of this study was to determine whether parameters of ovarian blood flow distinguish between women with polycystic ovary syndrome (PCOS) who ovulate and those who are anovulatory. STUDY DESIGN: This was a prospectively enrolled trial, carried out as a cross-sectional comparison of 12 ovulatory patients with PCOS and 20 matched subjects with classic PCOS and 10 healthy control subjects. Hormonal parameters and ovarian blood flow by color flow Doppler imaging were obtained in the early follicular phase. RESULTS: Characteristic elevations in luteinizing hormone (LH) and androgens were found in both groups with PCOS compared with control groups. Women with anovulatory PCOS had high insulin levels and lower Quantitative Insulin-Sensitivity Check Index (QUICKI) values compared with women with ovulatory PCOS, although both groups had values that were different from healthy control subjects (P<.01). Ovarian volume was similar in the two groups with PCOS, but pulsatility and resistance indices were lower in anovulatory PCOS (P<.01) compared with ovulatory PCOS and control subjects, who had similar findings. Insulin correlated negatively with the resistance index and QUICKI correlated positively (r=0.653, P<.01). There was a negative correlation between the resistance index and unbound testosterone (r=-0.5, P<.05). CONCLUSION: These data suggest that differences in ovarian blood flow in anovulatory versus ovulatory women with PCOS and that hormonal factors, including insulin resistance, may influence this relationship. The alterations in blood flow in anovulatory PCOS may contribute toward or result from anovulation.