The plasminogen activator system in women with polycystic ovary syndrome

Objective: To evaluate the plasminogen activator system in women with polycystic ovary syndrome (PCOS). Design: Case-control study. Setting: A district general hospital in the United Kingdom. Patient(s): Eleven women with PCOS and 12 controls. Intervention(s): Venipunctures for assays of the plasminogen activator system. Main Outcome Measure(s): Euglobulin clot lysis times, plasminogen activator inhibitor 1 (PAI-I) activity, fibrinogen, plasminogen, and alpha-2 antiplasmin concentrations in plasma. Result(s): Women with PCOS had a significantly longer euglobulin clot lysis time (mean +/- SD, 389 +/- 164 minutes vs. 220 +/- 110 minutes), a higher PAI-I activity (mean +/- SD, 19.7 +/- 12 arbitrary units (AU) per mt vs. 10.9 +/- 7.9 AU/mL), and a higher fibrinogen level (mean +/- SD, 4.02 +/- 0.64 g/L vs. 3.15 +/- 0.6 g/L) compared to controls. Conclusion(s): Women with the PCOS may have an imbalance in the plasminogen activator system that is tilted toward a reduced production of the proteolytic enzyme plasmin. Systemically, this may increase their risk of cardiovascular disease, but at cellular level in the ovaries, it may result in impaired follicular rupture and anovulation. (C) 1998 by American Society for Reproductive Medicine.