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 ova rian fraction of primordial follicles and, in adolescence, a uterus and ova ries of small size. We have now examined whether reduced prenatal growth is also followed by changes in the relationships among FSH, inhibin B and est radiol 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 concentratio ns were measured in the early follicular phase (range: day 5 +/- 3). SGA gi rls 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 poin ts to hyporesponsiveness of the ovarian granulosa cell fraction and that is reminiscent of reproductive aging. In conclusion, the gynecological correl ates of prenatal growth restriction are herewith extended to include ovaria n hyporesponsiveness to FSH in adolescence.