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Background  It is reported that growth hormone (GH) can alleviate oxidative stress (OS) induced apoptosis in some types of cells by activating the PI3K/Akt signaling pathway. This study investigated the role and underlying mechanism of GH in OS and apoptosis in granulosa cells (GCs) of patients with polycystic ovary syndrome (PCOS).    Methods  Primary GCs were collected from patients with and without PCOS (controls,  n  = 32) during oocyte retrieval. The patients with PCOS were randomly assigned to take GH treatment (PCOS-GH,  n  = 30) or without GH treatment (PCOS-C,  n  = 31). Reactive oxygen species (ROS) level was determined by spectrophotometry and fluorescence microscopy. GC apoptosis and mitochondrial membrane potential (MMP) were detected by Annexin V-FITC/PI double-staining and JC-1 staining, respectively (flow cytometry). The expression of apoptosis-related genes and proteins involved in PI3K/Akt signaling was determined by quantitative reverse-transcription polymerase chain reaction and western blotting, while active caspase-9 and caspase-3 levels of GCs were determined by enzyme-linked immunosorbent assay.    Results  Our study found that in GCs of the PCOS-GH group, the ROS levels and apoptotic rates were significantly decreased, whereas MMP was significantly increased when compared to those in the PCOS-C group ( P  < 0.05). The mRNA levels of  FOXO1 ,  Bax ,  caspase-9 , and  caspase-3  were significantly decreased, whereas  Bcl-2  was increased in GCs of the PCOS-GH group than those in the PCOS-C group ( P  < 0.05). The protein levels of FOXO1, Bax, cleaved caspase-9/caspase-9 and cleaved caspase-3/caspase-3 were decreased, whereas p-PI3K/PI3K, p-Akt/Akt, p-FOXO1 and Bcl-2 were increased in GCs of the PCOS-GH group, compared with those in the PCOS-C group ( P  < 0.05).    Conclusion  OS induced apoptosis and downregulated the PI3K/Akt signaling pathway in patients with PCOS. GH could alleviate apoptosis and activate the PI3K/Akt signaling pathway.    Clinical trial registration number  Chinese Clinical Trial Registry.  ChiCTR1800019437 . Prospectively registered on October 20, 2018.

Growth hormone activates PI3K/Akt signaling and inhibits ROS accumulation and apoptosis in granulosa cells of patients with polycystic ovary syndrome