HUMAN OVARIAN RESPONSE TO GONADOTROPHINS WITH DIFFERENT RATIOS OF FOLLICLE-STIMULATING HORMONE: LUTEINIZING HORMONE ASSESSED BY DIFFERENT PARAMETERS

Abstract

SUMMARY Eight women with secondary amenorrhoea were treated, four at each of two centres. They were each given four preparations of gonadotrophin having different ratios of follicle-stimulating hormone (FSH) to luteinizing hormone (LH) and the order of treatment with the preparations was determined at each centre by a latin square design. At the completion of these treatments each patient received a fifth preparation of gonadotrophin. The dosage of FSH was determined for each woman by a previous sensitivity test and remained constant for each of her 5 months of treatment. Each gonadotrophin preparation was given in approximately equal daily injections on days 1, 2 and 3 of each course of treatment and was invariably followed by a single injection of 12000 i.u. human chorionic gonadotrophin on the 10th day. Treatment was assessed by the measurement of the excretion of oestriol and pregnanediol, by vaginal cytology, by the degree of ferning of cervical mucus and by the basal body temperature (BBT). The administration of gonadotrophin with a ratio of FSH:LH < 1·0 produced a greater excretion of oestriol than gonadotrophin with a ratio of FSH:LH > 4·0. There was no significant loss of sensitivity to treatment with time. The karyopyknotic index was correlated with the excretion of oestriol but neither was of use in predicting the other because of the wide scatter. There was no correlation between the degree of ferning and the excretion of oestriol. Assessments of ovulation by the pregnanediol response and by the BBT were in good agreement. These results are discussed.