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Cited by 128Ovarian function and disordersReproductive Biology and FertilityDiabetes, Cardiovascular Risks, and Lipoproteins

The Impact of Insulin Secretion on the Ovarian Response to Exogenous Gonadotropins in Polycystic Ovary Syndrome

Fulghesu, Anna Maria, Villa, Paola, Pavone, Virginia, Guido, Maurizio, Apa, Rosanna, Caruso, Alessandro, Lanzone, Antonio, Rossodivita, Aurora +1 more·1997·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jcem.82.2.3727
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Abstract

The aim of the study was to evaluate the influence of insulin level on the ovarian response to FSH when inducing ovulation in patients affected by polycystic ovarian syndrome (PCOS). To evaluate the presence of hyperinsulinemia, 34 patients affected by PCOS were studied by an oral glucose tolerance test, then patients were stimulated for 52 cycles using FSH to induce ovulation. The ovarian response to therapy was evaluated by ultrasounds and as estradiol (E2) and androstenedione (A) plasma level determinations. On the basis of the insulinemic response to the glucose challenge, 20 patients were considered to be hyperinsulinemic and 14 normoinsulinemic. The hormonal features of each group were similar. The ovulation rate was similar in hyperinsulinemic and normoinsulinemic subjects, whereas the incidence of ovarian hyperstimulation was significantly higher in the hyperinsulinemic group. The increase in ovarian dimensions observed in hyperinsulinemic subjects after gonadotropin stimulation was more marked than that observed in normoinsulinemic ones. This was caused by the development of a larger number of immature follicles. E2 levels gradually increased after gonadotropin stimulation in both groups of subjects; however, higher levels were observed in hyperinsulinemic patients. During stimulation, the higher E2/A ratio suggests the presence of a greater aromatization activity in hyper-insulinemic patients. In conclusion, the present study suggests that, in PCOS, the insulinemic pattern may influence the ovarian response to gonadotropin administration; thus, hyperinsulinemic subjects may be at greater risk of ovarian hyperstimulation syndrome than normoinsulinemic subjects.

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Crossref · 10.1210/jcem.82.2.3727

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  • Compensatory hyperinsulinemia caused by insulin resistance may lead to excessive activation of IGF-1 and directly stimulate theca cells to produce androgens, exacerbating hyperandrogenism and inhibiting follicular development and ovulation.

    “Additionally, compensatory hyperinsulinemia caused by IR may lead to excessive activation of IGF-1 and it can directly stimulate theca cells to produce androgens, exacerbating hyperandrogenism and inhibiting follicular development and ovulation, thus worsening the symptoms associated with PCOS15,16.”

    From Efficacy and safety of GLP-1 receptor agonists on weight management and metabolic parameters in PCOS women: a meta-analysis of randomized controlled trials (2025) · cites this paper as [16]

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Authors
Fulghesu, A. M., Villa, P., Pavone, V., Guido, M., Apa, R., Caruso, A., Lanzone, A., Rossodivita, A., & Mancuso, S.
Affiliations
Università Cattolica del Sacro Cuore (IT)
Corresponding author
Fulghesu, Anna Maria
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
1997-02
Volume
82
Issue
2
Pages
644-648
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jcem.82.2.3727
OpenAlex
W2111800194
Cited by
128
References
17
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2017: 7 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 2 · 2012: 7
FWCI
4.65
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
  • Archive of Doctoral Theses and Digital Collections (University of Calabria) (submittedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
polycystic ovary syndrome, hyperinsulinemia, insulin resistance, ovarian hyperstimulation syndrome, estradiol, androstenedione, aromatization, immature follicles, ovulation rate
MeSH terms
Insulin Secretion, Adult, Androgens, Aromatase, Estradiol, Female, Follicle Stimulating Hormone, Glucose Tolerance Test, Ovarian Follicle, Humans, Hyperinsulinism, Insulin, Ovary, Ovulation Induction, Polycystic Ovary Syndrome, Ultrasonography, Incidence, Ovarian Hyperstimulation Syndrome

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