OESTROGEN AMPLIFICATION OF LH-RH RESPONSE IN THE POLYCYSTIC OVARY SYNDROME AND RESPONSE TO CLOMIPHENE

Abstract

An LH-RH [luliberin] test was performed before and 44 and 92 h after treatment with 2.5 mg estradiol benzoate in 17 patients with a diagnosis of polycystic ovarian (PCO) disease. The responses were compared with the same tests performed on 10 normal subjects during the early follicular phase of their menstrual cycles (days 4-6). Patients were divided into 2 groups on the basis of their LH [lutropin] responses to LH-RH. In Group A (7 patients) the response at 92 h was greater than at 44 h as in the normal subjects, but in Group B (10 patients) the response at 44 h was greater than at 92 h. Basal serum hormone values were similar in the 2 groups except for androgens and estrone, which were significantly (P < 0.01) higher in Group B patients. There was a negative correlation between the basal androgen and estrone concentrations and the LH and FSH [follitropin] amplifications at 92 h in all PCO patients. The ratios of the basal concentrations of LH to FSH and the ratios of the highest levels of each achieved during the basal LH-RH test, were significantly higher in the 2 groups of patients when compared to controls (P < 0.01). The test is of value in predicting the subsequent responsiveness to clomiphene. All patients in Group A showed evidence of ovulation following treatment with 100 mg clomiphene for 5 days, but only one of Group B responded in this way.