Serum total renin levels after ovarian electrocautery in women with polycystic ovary syndrome

Recent observations have suggested an enhanced activity of the ovarian reni n-angiotensin system in polycystic ovary syndrome (PCOS). Owing to technica l restrictions, the direct measurement of ovarian renin-angiotensin activit y is impossible. The measurement of total renin (active renin + prorenin) i n serum is particularly valuable for analyzing the ovarian renin-angiotensi n system, as 90% of circulating renin is in the form of prorenin and ovarie s are the major extrarenal source of prorenin in females. Also, the renin s ynthesized by ovaries is in the form of prorenin. In the present study we h ypothesized that ovarian trauma caused by electrocautery 'impairs' the acti vity of the ovarian renin-angiotensin system, which in turn would interrupt the endocrine vicious cycle of PCOS, and restore normal ovarian function. To test this, we examined the effect of ovarian electrocautery on serum lev els of total renin in 11 oligomenorrheic women, aged 25 to 36 years, with P COS and anovulatory infertility. Against our basic hypothesis the serum tot al renin levels remained unaltered after ovarian electrocautery, while the serum levels of luteinizing hormone, testosterone and androstenedione decli ned. The mechanism that induces ovulation without altering total renin leve ls in serum remains to be resolved.