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PubMed1992

Variability of serum gonadotropin and dehydroepiandrosterone sulfate concentrations in women with polycystic ovary syndrome.

This study was designed to assess the variability of luteinizing hormone (LH), follicle-stimulating hormone (FSH) and dehydroepiandrosterone sulfate (DHEAS) levels over time in women with polycystic ovary syndrome (PCOS). Serum LH, FHS and DHEAS concentrations were determined for four consecutive monthly intervals in three groups of women: group 1, normal cycling women in the follicular phase (n = 9); group 2, normal cycling women in the luteal phase (n = 10); and group 3, women with PCOS (n = 11). For LH, DHEAS and the LH/FSH ratio, a histogram was constructed based on whether the subjects in each group had 0, 1, 2, 3 or 4 high values. In addition, the coefficient of variation (CV) for the four individual values of each hormone was determined for each subject to quantitatively assess the variability of measurement over time. Histographic analysis revealed that an elevated LH value or an elevated LH/FSH ratio in PCOS was inconsistent. For DHEAS, 9 of 11 PCOS subjects had either 0 (n = 7) or 4 (n = 2) high values, suggesting that such determinations are relatively consistent. We conclude that (1) isolated LH or LH/FSH measurements may not be sufficiently reproducible to be clinically useful despite evidence that LH values may be more stable in PCOS than in normal women and (2) a normal or high DHEAS value in PCOS is more likely to be consistently replicated, although the number of subjects studied limits the power of this conclusion.

Adult↗

PubMed2003

[Expression of leptin and long form of leptin receptors messenger ribonucleic acid and protein in endometrium of patients with polycystic ovary syndrome].

OBJECTIVE: To study the expression of leptin and long form of leptin receptors (Ob-R(L)) messenger ribonucleic acid (mRNA) and protein in endometrium during mid-luteal phase of patients with polycystic ovary syndrome (PCOS). METHODS: The expression of leptin and Ob-R(L) mRNA in endometrium during mid-luteal phase from 15 normal controls and 14 PCOS related anovulatory patients who underwent ovulation induction therapy were studied by in situ hybridization, and levels of leptin and Ob-R(L) protein were investigated by immunohistochemical methods. RESULTS: The expression of Ob-R(L) mRNA and protein in endometrial glands of most patients with PCOS were weak or moderate positive, whereas the levels of Ob-R(L) mRNA and protein were moderate or strong positive in those of the controls, there was significant difference between the two groups; leptin mRNA and protein expression in endometrium of patients with PCOS and controls were not significantly different between the groups. CONCLUSION: The expression of Ob-R(L) decreased in endometrium of mid-luteal phase in patients with PCOS during induced ovulation, which may be related to low pregnancy rate of patients with PCOS.

Adult↗

PubMed2003

Serum leptin levels in normal-weight and overweight women with polycystic ovary syndrome.

The aim of this study was to evaluate serum leptin levels in women with polycystic ovary syndrome (PCOS) and in controls with normal or abnormal body mass index (BMI), since the literature data are contradictory. The study population comprised 34 women with PCOS and 30 regularly cycling women, with normal or abnormal BMI. PCOS was defined by clinical, ultrasonographic, and hormonal findings. The women were divided into four groups according to the diagnosis of PCOS and their BMI values. In all women serum levels of FSH, LH, prolactin, testosterone, androstenedione, DHEA-S, 17alpha-OH progesterone, SHBG, insulin, glucose and leptin were determined. It was found that: (a) there was a significant interaction between BMI and PCOS in increasing serum leptin levels; (b) the dominant factor for serum leptin levels in women of all Groups was BMI, followed by insulin; (c) once we corrected for BMI, it was found that there was a significant correlation between serum leptin levels and insulin values, as well as between serum leptin levels and testosterone concentrations; and (d) the QUICKI IR formula presented the most significant correlation with serum leptin levels than the other measures of insulin sensitivity. Our results showed that serum leptin levels in a subgroup of overweight women with PCOS and insulin resistance were higher than those expected for their BMI, and therefore leptin might interfere in the pathogenesis of this syndrome.

Adolescent↗

PubMed2003

[Effects of metformin on gonadotropin-induced ovulation in patients with polycystic ovary syndrome].

OBJECTIVE: To evaluate the effects of metformin on gonadotropin-induced ovulation in patients with polycystic ovary syndrome (PCOS). METHODS: Forty patients with PCOS (study group) and 20 women with normal weight and menstrual cycle (control group) were enrolled. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), fasting glucose (FG), fasting insulin (FINS) and fasting leptin were measured before and after treatment. In the study group, 20 cases (group A) were assigned to take 500 mg of metformin three times daily for 12 weeks, if pregnancy did not occur, high purified FSH (FSH-HP) was added for one cycle; another 20 cases (group B) were induced ovulation with FSH-HP alone for one cycle. RESULTS: There were significant high FINS and leptin levels in the study group as compared with the control group [(20 +/- 16) vs (12 +/- 6) nmol/L, P < 0.05; (14 +/- 16) vs (8 +/- 4) mg/L, P < 0.05]. The obese PCOS group had markedly higher serum FINS and leptin than the non-obese PCOS group [(24 +/- 18) vs (14 +/- 8) nmol/L, P < 0.05; (20 +/- 22) vs (8 +/- 4) mg/L, P < 0.05], but serum FINS and FG were not significantly different between the non-obese PCOS and the control group (P > 0.05). After administration of metformin for 12 weeks, serum LH, T, leptin and FINS decreased significantly (P < 0.05 - 0.01), serum FSH levels and body mass index showed a slight decrease, whereas no change was found in FG. In the study group, 3 cases conceived during metformin therapy, the remaining 37 were induced ovulation with FSH-HP or FSH-HP and metformin, 7 cases obtained pregnancy. The rates of ovulation and pregnancy in group A were higher than those in group B (88% vs 70%, 24% vs 15%), but no significant difference was found. CONCLUSIONS: Metformin therapy in PCOS can decrease the FINS and leptin levels, normalize the endocrine abnormalities, resumes ovulation and pregnancy in some patients, and may improve the ovarian response to gonadotropin.

Adult↗

PubMed2004

[Diagnosis of polycystic ovary syndrome].

Polycystic ovary syndrome (PCOS) is the most common endocrine disorders among women in reproductive age, but diagnostic criteria used in clinical practice are still controversial. In 1990 the National Institute of HEALTH (NIH) conference on PCOS recommended that diagnostic criteria should include biochemical evidence of hyperandrogenism and ovarian dysfunction (in the absence of non-classical adrenal hyperplasia) without considering the morphological diagnosis of polycystic ovary by ultrasound as an essential part of the diagnosis. In the Rotterdam PCOS workshop of May 2003, however, PCOS is diagnosed when 2 of the following criteria are recognized: oligomenorrhea and/or anovulation, clinical or biochemical signs of hyperandrogenism, ultrasound findings of polycystic ovary. Further-more, it is underlined that the metabolic study is not necessary for PCOS diagnosis, while it is suggested for "at risk patients" (obesity, diabetes, familiar and obstetrical history) with an oral glucose tolerance test (OGTT). A recent study carried out by our group underlined the role of ultrasound parameter, in particular suggesting a ratio between ovarian stroma area and total area of the ovarian section (S/A), with a cut-off of 0.34, as "gold parameter" for PCOS diagnosis, because it shows high sensitivity and specificity (96.3%, 97.0% for the S/A).

Adult↗

PubMed2004

Polycystic ovary syndrome and cardiovascular disease.

The aim of the present paper is to analyze recent literature concerning the incidence of cardiovascular complications in women suffering from polycystic ovary syndrome (PCOS). The study takes into consideration all the studies that have been published to date in the international literature in order to clarify whether or not PCOS is able to determine an early onset or whether it is responsible for a higher global incidence of cardiovascular complications in adult age. The main difficulty lies in the absence of prospective studies owing to the long period of time existing between the diagnosis of PCOS and cardiovascular disease which notoriously has a long latency period. Much attention has been paid in the literature, on the other hand, to the analysis of the incidence of cardiovascular risk factors in women suffering from PCOS. Although epidemiological studies have not evidenced an increased incidence of death from cardiovascular events in women suffering from PCOS, the above conclusions might well be invalidated by a patient selection bias, by obsolete diagnostic criteria or by medical or surgical therapies that could influence the outcome of the disease and which are not considered as a confusion factor. Undoubtedly, all the data available up to the present suggest that PCOS possesses the intrinsic conditions that lead to an increased incidence of factors predisposing to cardiovascular diseases. Future longitudinal studies of a prospective nature might be useful for understanding whether the higher incidence of predisposing factors might also lead to greater expectation of cardiovascular events or whether medical therapies or other factors (improvement in endocrine symptomatology with the menopause?) may prevent the increase in the expected incidence of these events.

Biomarkers↗

PubMed2004

[Clinical study on treating insulin resistance and promoting ovulation in polycystic ovary syndrome].

OBJECTIVE: To investigate the effects of metformin and clomiphene on infertility caused by polycystic ovary syndrome (PCOS) with insulin-resistance (IR) and to observe the effects of metformin on PCOS with pseudoacanthosis nigricans (AN) and IR. METHODS: Seventy infertility patients caused by PCOS with IR were randomly divided into three groups : patients in group Aa (n = 20) took metformin 500 mg only, three times daily for 3 months; patients in group Ab (n = 20) took clomiphene 50 mg only, once daily from the 5th day of menstrual cycle or withdrawal bleeding for 5 days and 3 cycles, and patients in group Ac (n = 30) were treated by metformin and clomiphene for 3 cycles, with the same dosages as groups Aa and Ab. Thirty patients who suffered from PCOS with AN and IR were served as group B, They took metformin only, the same as group Aa. The following indexes were measured before and after three months or cycles of treatment in all the patients: body height, weight, waistline, hipline, body mass index (BMI), waist hip ratio (WHR), fasting insulin (FINS), fasting blood-glucose (FBG), total cholesterol (TC), triglyceride (TG), and sex hormones [follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL), estradiol (E(2)), progestin (P), testosterone (T)]. RESULTS: The pregnant rate was 15% (group Aa), 20% (group Ab), and 57% (group Ac) respectively. It was significantly higher in group Ac than in groups Aa and Ab, (P < 0.01), while there was no significant difference between the latter two groups (P > 0.05). In group Ac the pretreatment levels of FINS, BMI, T, TG, and TC were (49.7 +/- 6.4) mU/L, 29.4 +/- 2.2, (6.4 +/- 2.2) nmol/L, (4.1 +/- 1.0) mmol/L, (6.3 +/- 0.5) mmol/L, and posttreatment levels were (27.7 +/- 1.8) mU/L, 23.6 +/- 5.2, (3.8 +/- 2.0) nmol/L, (2.2 +/- 0.7) mmol/L, (4.6 +/- 0.5) mmol/L. In group Aa pretreatment levels of FINS, BMI, T, TG, and TC were (50.0 +/- 8.2) mU/L, 28.7 +/- 1.2, (6.4 +/- 2.0) nmol/L, (4.3 +/- 1.2) mmol/L, (6.6 +/- 0.3) mmol/L, and posttreatment levels were (29.9 +/- 8.2) mU/L, 22.4 +/- 9.3, (4.3 +/- 0.9) nmol/L, (2.3 +/- 0.3) mmol/L, (4.8 +/- 0.6) mmol/L. In group B pretreatment levels of FINS, BMI, T, TG, and TC were (51.0 +/- 8.1) mU/L, 29.8 +/- 3.1, (6.3 +/- 3.5) nmol/L, (4.5 +/- 1.2) mmol/L, (6.8 +/- 0.2) mmol/L, and posttreatment levels were (28.5 +/- 2.8) mU/L, 23.4 +/- 6.1, (3.0 +/- 0.9) nmol/L, (2.3 +/- 0.9) mmol/L, (5.0 +/- 0.6) mmol/L. In groups Ac, Aa and B, the IR condition was obviously improved and posttreatment serum levels of T, TG, TC, FINS and BMI were significantly lower than those of pretreatment (all P < 0.01). In group Ab pretreatment levels of FINS, BMI, T, TG, and TC were (48.8 +/- 7.4) mU/L, 27.3 +/- 2.8, (6.0 +/- 2.0) nmol/L, (3.9 +/- 1.4) mmol/L, (6.4 +/- 0.6) mmol/L, and posttreatment levels were (42.9 +/- 7.0) mU/L, 27.5 +/- 3.1, (4.0 +/- 2.4) nmol/L, (3.9 +/- 0.3) mmol/L, (5.9 +/- 0.3) mmol/L, (all P > 0.05). Among patients in group B, 90% (27/30) menstrual condition and ovulation function were improved and AN was reduced in different degree after three months' treatment. CONCLUSION: Metformin can increase the sensitivity of PCOS to clomiphene and improve ovulation function of clomiphene. Metformin plus clomiphene is an effective way of treating infertility caused by PCOS with IR.

Adult↗

PubMed2004

Psychosocial and sociocultural aspects of infertility--a comparison between Austrian women and immigrant women.

The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study we examined psychosocial parameters caused by infertility in PCOS women with different socio-cultural background. Symptomatology of PCOS, body composition characteristics as well as psychosocial parameters were examined in 49 PCOS infertility patients of the University Clinic for Gynecology and Obstetrics in Vienna, who originated from two different socio-cultural subgroups--Austrian women and Moslem immigrant women. In the appearance of the symptoms the typical heterogeneity of PCOS could be found in both subgroups with no differences. However, differences in the psychosocial aspects were impressive. Women from Islamic background do have a very high reproductive pressure. The Moslem immigrant PCOS women suffer more from infertility than Austrian women do.

Adolescent↗

PubMed2004

[The differential expression profile of polycystic ovary syndrome associated genes].

OBJECTIVE: To explore the gene differential expression pattern of polycystic ovary syndrome. METHODS: We carried out microarray analysis to define the gene networks by the PCOS granulosa cells in order to identify differentially expressed genes in PCOS patients. These granulosa cells of five PCOS cases and five control cases which were derived during oocyte retrieval from women undergoing IVF. RESULTS: As compared with control human ovarian granulosa cells, 46 genes were screened out, 25 genes were up-regulated, and 21 genes were down-regulated in PCOS. These differentially expressed genes were involved in various biologic functions, such as regulation of fatty acid metabolism, cell-cell signal transduction, immune and inflammatory response, reflecting the complexity of clinical manifestations of PCOS. CONCLUSION: Microarray analysis technology is an effective method to identify novel PCOS associated candidate genes.

Adult↗

PubMed2005

[Relationship between the microsatellite polymorphism of CYP11 alpha gene and the pathogenesis of hyperandrogenism of polycystic ovary syndrome in Chinese].

OBJECTIVE: To explore the association between the microsatellite polymorphism in the promoter region of CYP11 alpha gene and hyperandrogenism of polycystic ovary syndrome (PCOS). METHODS: Eighty-six cases of PCOS and 50 normal women as controls were studied. Polymerase chain reaction and electrophoresis on polyacrylamide gel were employed to detect the polymorphism of CYP11 alpha gene and its frequency distribution. At the same time, the relationships of CYP11 alpha alleles to serum testosterone levels in PCOS were compared. RESULTS: Four different CYP11 alpha (tttta)n alleles were identified, corresponding to 4, 6, 8 and 9 repeat-units alleles. The frequency distribution profiles were 0.17, 0.31, 0.39, 0.13 and 0.22, 0.35, 0.33, 0.10 in PCOS group and control group respectively, showing no statistically significant difference between the two groups. There were no correlations between the polymorphism of CYP11 alpha gene and the serum testosterone levels of PCOS patients. CONCLUSION: Micro-satellite polymorphism (tttta)n of gene CYP11 alpha exists in Chinese women and the polymorphism does not relate to the pathogenesis of hyperandrogenism in women with PCOS.

Adult↗

PubMed2005

[Polycystic ovary syndrome].

Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by chronic unovulation, hyperandrogenism and polycystic change in ovary. Hyperinsulinemia is so often accompanied with PCOS that insulin resistance may play important roles in pathogenesis of PCOS. Recent studies reported the effectiveness of insulin-sensitizing drugs on treatment of patients with PCOS. Thiazolidinedione, an agonist of PPARgamma receptor, improves not only insulin sensitivity but also hyperandrogenism and ovulatory dysfunction in patients with PCOS. Insulin-sensitizing drugs such as thiazolidinediones are expected to be a novel therapy for PCOS, although further studies on the effectiveness and safety should be required.

Female↗

PubMed2005

[Polycystic ovary syndrome].

INTRODUCTION: In May 2003, leading American and European experts reached a consensus for the definition of polycystic ovary syndrome (PCOS). This consensus implies that the same criteria can be used when research on PCOS is performed, which is fundamental to further knowledge development. MATERIAL AND METHODS: The present review is based on a search in PubMed/Medline and personal clinical experience. RESULTS AND INTERPRETATION: Based on existing knowledge, women with PCOS have an increased risk of overweight, insulin resistance, type 2 diabetes mellitus, cardiovascular disease, and most likely certain types of gynaecologic cancer. Treatment of PCOS should therefore not only be symptomatic, focusing on existing symptoms. In addition, prophylactic measures should also be initiated. This change in treatment philosophy is a huge challenge to all doctors. In order to correctly diagnosing PCOS, general practitioners need to co-operate with gynaecologists. For optimal management of PCOS, general practitioners as well as gynaecologists have to be aware of the diagnostic criteria; the syndrome should be diagnosed as early as possible and the patient informed about the syndrome. The doctor and the patient should decide upon a long-term follow-up strategy together.

Consensus↗

PubMed2006

Association of polymorphisms in the beta2 and beta3 adrenoceptor gene with polycystic ovary syndrome.

OBJECTIVE: To investigate polymorphisms of the beta2 and beta3 adrenoceptor (BAR-2 and BAR-3, respectively) genes associated with insulin-resistant polycystic ovary syndrome (PCOS) pathogenesis. STUDY DESIGN: Fifty-nine infertile Japanese women with PCOS and 97 healthy Japanese controls were studied. Blood metabolites and genomic DNA polymorphisms of BAR-2 (Arg16Gly and Gln27Glu) and BAR-3 (Trp64Arg) were analyzed. RESULTS: The PCOS group had significantly higher weight, body mass index, lipidemia and insulin resistance as compared to the control group. Glu 27 allele frequency in BAR-2 was significantly higher in PCOS patients as compared to the controls (0.07 vs 0.02, chi2 = 5.91, p = 0.02, OR 4.63, 95% CI 1.35-5.93), while Gly 16 allele frequency was only slightly higher in the PCOS group as compared to the controls (0.58 vs. 0.47, chi2 = 3.06, p = 0.08, OR 1.51, 95% CI 0.95-2.40). The Arg 64 allele frequency of BAR-3 was not significantly different between the 2 groups. Women with the Gly/Gly genotype for codon 16 or with either the Gln/Glu or Glu/Glu genotype for the codon 27 polymorphism of BAR-2 had significantly higher insulin resistance than those with the Arg/Arg and Gln/Gln genotypes. CONCLUSION: The polymorphism in codon 27 (Gln27Glu) of BAR-2 is linked to the expression of PCOS in Japanese women.

Adult↗

PubMed2006

Increased serum neopterin levels in women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) occurs in 5-10% of premenopausal women. Studies suggest that PCOS is associated with increased risk of coronary heart disease (CHD). To investigate this relationship, 15 PCOS women (group 1) and 10 healthy women (group 2) were studied. Blood leukocyte counts (white blood cells, WBC) and serum levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, sensitive C-reactive protein (sCRP), and neopterin were measured in the 2 groups. There were no significant differences in serum total cholesterol, HDL-cholesterol, or LDL-cholesterol concentrations between groups 1 and 2. Blood WBC counts and serum levels of neopterin and sCRP were significantly higher in group 1 than group 2. The median (min-max) levels were: WBC, group 1: 8.05 (5.10-9.70) cells x 10(9)/L, group 2: 6.25 (4.70-9.70) cells x 10(9)/L (p <0.01); neopterin, group 1: 10.6 (7.5-49.5) nmol/L, group 2: 9.6 (6.5-12.9) nmol/L (p < 0.05); and sCRP, group 1: 7.0 (1.2-12.0) mg/L, group 2: 2.0 (0.1-12.0) mg/L (p <0.01). This study shows that blood WBC counts and serum sCRP and neopterin levels are significantly elevated in women with PCOS. These findings support an increased risk for early-onset cardiovascular disease in women with PCOS. This is the first report that women with PCOS have higher serum neopterin levels than healthy women with regular menstrual cycles.

Adolescent↗

PubMed2006

Weight change and androgen levels during contraceptive treatment of women affected by polycystic ovary.

OBJECTIVE: The aim of this study was to investigate the effect of oral contraceptive Diane 35 (ethinylestradiol + cyproteroneacetate EE/CPA) which is widely used in the treatment of PCOS in Europe, on body weight, lipid levels and endocrine parameters in non-obese women with PCOS. SUBJECTS AND METHODS: Nineteen PCOS women were examined in the early follicular phase of menstrual cycle, blood samples for the estimation of cholesterol (C), HDL cholesterol (HDL-C), triglycerides (TG), testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS) and sex hormone binding globulin (SHBG) were taken before the start of treatment with Diane 35 and again after 7 +/- 3.8 months of treatment with Diane 35. Body weight (W) was recorded at the time of both examinations. RESULTS: After the treatment with Diane 35 the levels of W (p<0.05), total C (p<0.05), TG (p<0.004) and SHBG (p<0.0001) increased significantly. In addition, significant negative correlation between SHBG levels before treatment and increase of W after Diane 35 was found (r= -0.56; p<0.02). Increase of W correlated negatively with T before treatment (r= 0.58; p< .02) and positively with the change in T level after treatment (r=0.50; p<0.05). CONCLUSIONS: Increase of body weight in a significant number of PCOS-affected women was seen after treatment with Diane 35 and it is assumed to blunt ameliorating effects of this treatment on androgen levels. Considering our findings, we conclude that the treatment with CPA/EE can result in significant weight gain ameliorating positive effects of the treatment on androgen levels. These findings could underline the necessity of the finding new therapeutical options for PCOS, besides contraception. Studies concerning body composition during contraceptive treatment in PCOS would be also useful in the future.

Adult↗

PubMed1991

Gestational diabetes and neonatal macrosomia in the polycystic ovary syndrome.

Since patients with polycystic ovary syndrome (PCOS) commonly have insulin resistance, albeit with normal glucose tolerance, we evaluated glucose tolerance in PCOS patients exposed to the diabetogenic effect of pregnancy. The clinical material was obtained from two centers, in Springfield, Illinois (22 patients), and New York, New York (31 patients), and the results were compared with a control population with 2,306 consecutive general pregnancies. There were no differences between PCOS patients from the two centers in regard to age or ponderal index (P greater than .1). A review of the medical records showed that the incidence of gestational diabetes in the PCOS patients was 7.5%, similar (P greater than .1) to the 6.6% frequency of gestational diabetes in the controls. The overall incidence of neonatal macrosomia (birth weight greater than 4,000 g) was 7% (4 of 57) among infants born to PCOS women. That was similar to the 12.4% incidence of neonatal macrosomia among infants born to women with normal glucose tolerance and to the 14.5% incidence among infants born to women with gestational diabetes. Preexisting PCOS does not appear to increase the risk of developing gestational diabetes or neonatal macrosomia.

Adult↗

PubMed1989

The polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a multifaceted clinical entity the hallmark of which is ovulatory dysfunction associated with a relative luteinizing hormone excess and follicle-stimulating hormone (FSH) deficiency. Clomiphene citrate has been the first-line drug for ovulation induction in women with PCOS: because it is an attenuated estrogen, its action blocks the acyclic estrone effect in PCOS. However, many women fail to ovulate or conceive on clomiphene, and an appropriate agent for them was unavailable until relatively recently. The use of a "pure" FSH preparation, Metrodin, provides physiologic replacement of the deficient gonadotropin in PCOS; thus, Metrodin is the ideal second-line drug. Its use with a low-dose regimen should avoid the hyperstimulation seen with human menopausal gonadotropin in PCOS; spontaneous ovulation is an end point. Thus, PCOS patients who do not achieve pregnancy with clomiphene citrate have available a new, more physiologic approach to ovulation induction.

Clomiphene↗

PubMed1989

A pharmacodynamic comparison of human urinary follicle-stimulating hormone and human menopausal gonadotropin in normal women and polycystic ovary syndrome.

We performed a pharmacodynamic comparison of human urinary follicle-stimulating hormone (hFSH) and human menopausal gonadotropin (hMG) to characterize differences in the bioavailability of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as to compare estrogen responses in normal women and those with polycystic ovary syndrome (PCOS). Ten women with PCOS and ten normal ovulatory controls were randomized to receive a single dose (2 ampules) of either hFSH or hMG. Serum LH decreased significantly following hFSH with responses occurring earlier in controls (24.5 +/- 10.9% after 30 minutes) than in PCOS patients (27.3 +/- 7.5% after 18 hours). After hMG, LH increased only in controls (33.8 +/- 16.3%). An FSH increment following hFSH was observed in both PCOS patients (54.7 +/- 24.8%) and controls (74.6 +/- 36.8%), with peak responses at 6 and 4 hours, respectively. However, after hMG, FSH increased only in controls. The LH/FSH ratio after hFSH decreased, with the nadir at 18 hours (1.438 +/- 0.183) being similar to baseline LH/FSH ratios of controls (1.433 +/- 0.341). Serum estradiol (E2) increased following hMG, with peak responses after 18 hours, in both PCOS patients (75.4 +/- 28.6%) and controls (88.5 +/- 32.5%). The peak E2 response to hFSH was observed to be earlier in PCOS patients (147 +/- 34%), occurring after 12 hours, compared with controls (58 +/- 29% after 18 hours).

Adult↗