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Effects of aging on menstrual cycle hormones and endometrial maturation
M C Batista1, T P Cartledge, A W Zellmer
1National Institute of Child Health and Human Development, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
Objective:
To investigate changes in menstrual cycle hormones and endometrial maturation that may contribute to the decline in fertility with aging.
Design:
Prospective controlled clinical study.
Setting:
Normal human volunteers in an academic research institution.
Subjects:
Women with regular menstrual cycles.
Interventions:
Thirty-two women, aged 20 to 30 or 40 to 50 years, had daily blood drawing starting on cycle day 6 to 10 and continuing until 2 days after the onset of next menses. In addition, 60 women, aged 20 to 30 or 40 to 50 years, had a total of 93 endometrial biopsies performed on day 7 to 9 after the LH surge.
Main Outcome Measures:
Serum LH, FSH, E2, inhibin, P, and placental protein 14 (PP14) levels and histologic maturation of the endometrium.
Results:
Serum FSH levels were increased whereas inhibin concentrations were reduced in the luteal-follicular transition of women > 40 years. No other hormonal changes were seen in this population, including P and PP14 secretion. Disruption of endometrial maturation occurred at a similar frequency in both age groups.
Conclusions:
Follicular recruitment, but not luteal function or endometrial maturation, is disturbed in cycling women > 40 years and may contribute to the decline in fertility with aging.