Horm Metab Res 2009; 41(5): 408-413
DOI: 10.1055/s-0028-1105918
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Assessment of Pituitary and Steroid Hormones and Members of the TGF-β Superfamily for Ovarian Function in Patients with Congenital Uterus and Vaginal Aplasia (MRKH Syndrome)

P. L. Strissel 1 , P. Oppelt 1 , S. Cupisti 1 , E. Stiegler 1 , M. W. Beckmann 1 , R. Strick 1
  • 1University-Clinic Erlangen, Department of Gynaecology and Obstetrics, Laboratory for Molecular Medicine, Erlangen, Germany
Further Information

Publication History

received 07.01.2008

accepted 06.11.2008

Publication Date:
19 December 2008 (online)

Abstract

Patients with Mayer–Rokitanski–Kuster–Hauser (MRKH) syndrome have congenital uterine and vaginal aplasia. The main question of this study was, if the absence of a uterus along with other genital and organ malformations could contribute to hormone or other growth factor protein fluctuations involved in communication between the hypothalamus-pituitary axis, ovaries and uterus. Serum from 56 MRKH patients (mean 27.6 years) and 22 female controls (mean 30.7 years) were analyzed using ELISA to determine levels of pituitary and steroid hormones (LH, FSH, estradiol, progesterone), growth factors of the TGF-β superfamily like activin A, inhibin B, and anti-Müllerian hormone (AMH). All serum levels were analyzed in relation to other organ malformations. Compared to controls, all 56 patients, including 5% with streak ovaries or unilateral ovarian aplasia, were generally similar in hormone and growth factor levels and could be grouped into hormonal phases. However, compared to controls LH/FSH and FSH/LH ratios of patients had significantly higher and lower mean values, of 2.75-fold (p=0.015) and 1.9-fold (p=0.002), respectively. Undetectable inhibin B levels of<10 pg/ml (p=0.05) were noted in 41.1% of MRKH patients, resulting in significantly higher activin A/inhibin B ratios (p<0.001). MRKH patients have hormonal phases supporting ovarian function, but patients with low FSH/LH ratios and undetectable inhibin B levels (<10 pg/ml) could represent cycle phasing irregularities. A model is discussed regarding our findings and the loss of ovarian-uterine communication.

References

Correspondence

Dr. R. Strick

Department of Gynaecology and Obstetrics

University-Clinic Erlangen

Laboratory for Molecular Medicine

Universitaetsstr. 21–23

91054 Erlangen

Germany

Phone: +49/9131/85 366 71

Fax: +49/9131/85 366 70

Email: Reiner.Strick@uk-erlangen.de