Antoni Duleba, MD

Ovarian function remains under control of a broad range of endocrine and paracrine agents. It is apparent that insulin and insulin growth factors play significant roles in the control of ovarian folliculogenesis and steroid genesis. Excessive levels of insulin and/or IGF-1 may be involved in the pathogenesis of a common endocrine disorder: Polycystic Ovary Syndrome (PCOS). Our recent data indicate that PCOS is associated with increased oxidative stress, systemic inflammation and dyslipidemia. These clinical observations are paralleled by our in vitro studies, whereby we observed that oxidative stress can mimic actions of insulin and IGF-1 and promote proliferation of cultured stromal and thecal cells, as well as increased production of androgens. Our current efforts are focused on determining the effects of oxidative stress, antioxidants, and their interactions with insulin and growth factors on the function of ovarian cells in culture and in clinical settings. Furthermore, we are investigating the effects of statins on ovarian function in vitro and in vivo. We have demonstrated that statins inhibit proliferation and steroidogenesis of theca-interstitial cells. In patients with PCOS, use of statin results in decreased levels of testosterone and improvement of LH to FSH ratio.