Characterizing the reproductive hormone milieu in infertile women with diminished ovarian reserve

Profound reduction of ovarian estrogen by aromatase inhibition in obese women

“…It is of interest, however, that the normal weight women had similar FSH transverse sums regardless of whether or not an AI was given. Although the unstimulated women were not concurrently collected controls [3,7,8] and therefore firm conclusions may not be drawn from these data, the lack of differences in FSH excretion suggests that increased absolute concentrations of circulating FSH may not be a primary mode of action for AIs. It is possible that AIs cause FSH output to differ qualitatively, possibly by altering the biological activity of secreted isoforms.…”

“…We studied daily, first-morning voided urine hormone patterns in regularly cycling, ovulatory, obese women stimulated with letrozole in the early follicular phase and compared these findings to normal weight women who received similar AI and a group of normal weight women who did not receive any ovulation stimulation medication who served as historical controls [7, 8]. …”

“…Women were excluded for excessive exercise, which was defined as greater than 4 hours per week. An additional 14 eumenorrheic, women who had not received any ovulation enhancing medication with a BMI of 18–25kg/m 2 who underwent the same daily urine collection methods and whose data have been previously reported [3,7,8] were used as a comparison group. Participants were recruited by local campus-wide postings and email study advertisements.…”

“…Urinary LH and FSH were measured using a DELFIA immunofluorometric assay platform and E1c and Pdg were measured using an in house ELISA. All hormones were normalized to creatinine as described [3,7,8]. The interassay and intra-assay coefficients of variation were: for LH 7.7% and 4.6%, respectively; for FSH 7.3% and 4.1%, respectively, for E1c 9.3% and 3.1%, respectively; for Pdg 16.8% and 6.9%, for E2 10.6% and 3.7%, respectively; for E1 11.7% and 6.4%, respectively.…”

“…Luteal activity and day of luteal transition were calculated using a previously validated algorithm that allowed us to determine whether ovulation had occurred and the likely day of ovulation [4]. Using this algorithm, luteal activity was first confirmed by identifying the Pdg nadir in the first 5 samples after menses and detecting a sustained, 3-fold rise from the nadir [3,5,7,8]. The day of luteal transition was calculated by a 60% drop in the E1c/Pdg ratio prior to the Pdg peak [4].…”