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Age-Related Analysis of Inhibin A, Inhibin B, and Activin A Relative to the Intercycle Monotropic Follicle-Stimulating Hormone Rise in Normal Ovulatory Women

Departments of Obstetrics and Gynecology (N.A.K., B.S.H., K.R.H., M.R.S.) and Medicine (W.J.B.), University of Washington, Seattle, Washington 98105; Departments of Neurobiology and Physiology (T.K.W.), Northwestern University, Evanston, Illinois 60208; and Reproductive Endocrine Unit Department of Medicine (P.M.S.), Massachusetts General Hospital, Boston, Massachusetts 02114

Address all correspondence and requests for reprints to: Nancy A. Klein, M.D., Division of Reproductive Endocrinology, 4225 Roosevelt Way NE, Suite 305, Seattle, Washington 98105. E-mail: nklein{at}u.washington.edu.

Previous studies have reported that the monotropic rise in FSH in older women is associated with decreased inhibin B and/or A levels and increased levels of activin A. Whereas most investigators have found decreased follicular-phase inhibin B, the roles of inhibin A and activin A as modulators of the FSH rise are unclear. The objectives of this study were to determine whether deficiencies in circulating levels of inhibin A, inhibin B, and/or activin A exist during the intercycle interval in ovulatory older (age, 40–45 yr; n = 16), compared with younger women (age, 20–25 yr; n = 13). Blood samples were obtained daily throughout one menstrual cycle and the follicular phase of the subsequent cycle and were analyzed for LH, FSH, estradiol, inhibin A and B, and activin A. Despite significant FSH elevation, no deficiencies in inhibin A, activin A, or estradiol were detected in older subjects. In fact, inhibin A was significantly higher in older participants during the intercycle phase (P = 0.01), whereas inhibin B was significantly lower. Thus, the monotropic rise in FSH does not appear to result from changes in inhibin A or activin A, supporting the concept that inhibin B plays a critical role in mediating the FSH rise in older women.

This work was supported by grants from the National Institute on Aging (Grant RO1-AG14579) and the National Institute of Child Health and Human Development (Grant U54-HD29164).

Abbreviation: CV, Coefficient(s) of variation.

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