Ovarian hyporesponsiveness to follicle stimulating hormone in adolescent girls born small for gestational age.

Girls with reduced prenatal growth are known to have, at birth, a small ovarian fraction of primordial follicles and, in adolescence, a uterus and ovaries of small size. We have now examined whether reduced prenatal growth is also followed by changes in the relationships among FSH, inhibin B and estradiol in adolescent girls. We studied 48 post-menarcheal girls (age 13.6 +/- 1.4 yr) who were either born with an appropriate weight for gestational age (AGA; n=33; mean weight 3.3 Kg) or born small for gestational age (SGA; n=15; mean weight 2.4 Kg). Serum FSH, inhibin B and estradiol concentrations were measured in the early follicular phase (range: day 5 +/- 3). SGA girls had, compared to AGA girls, elevated serum FSH (7.2 +/- 0.7 vs 4.5 +/- 0.3 IU/mL; p=0.0002), similar inhibin B (62.1 +/- 8.1 vs 60.7 +/- 6.5 pg/mL) and lower estradiol concentrations (12.1 +/- 1.5 vs 21.2 +/- 2.4 pg/mL; p=0.02). SGA girls thus displayed, early after menarche, a pattern that points to hyporesponsiveness of the ovarian granulosa cell fraction and that is reminiscent of reproductive aging. In conclusion, the gynecological correlates of prenatal growth restriction are herewith extended to include ovarian hyporesponsiveness to FSH in adolescence.