Gonadotrophin Control of Follicular Development

Abstract

In order to investigate the endocrine requirements for induction of follicle maturation, ovulation and luteal function we have measured plasma LH and FSH concentrations in 109 cycles induced by treatment with LHRH in 25 women with amenorrhoea of diverse aetiology. The major clinical and endocrine subgroupings were polycystic ovarian disease (PCO), Kallmann's syndrome, weight related amenorrhoea and hyperprolactinaemia. By analysis of variance of the LH and FSH concentrations obtained three times per week in the follicular phase in 77 ovulatory cycles (including 24 conception cycles), we found that in women with PCO the mean LH concentration was 19.5 IU/l. In hyperprolactinaemia and secondary amenorrhoea of non-specific aetiology the mean LH concentration was 11.6 IU/l and in patients with hypogonadotrophic hypogonadism and weight-related amenorrhoea it was 7.2IU/l. These mean LH concentrations were significantly different from each other (P less than 0.001). We speculate that the high LH concentrations in the follicular phase may impair the final stages of oocyte maturation and so contribute to the infertility of these patients. FSH concentrations in the follicular phase were lower in patients with hypogonadotrophic hypogonadism and weight-related amenorrhoea than in other groups. Although the differences were statistically significant (P less than 0.001) the difference was small (mean FSH in hypogonadotrophic hypogonadism and weight-related amenorrhoea 4.3 IU/l vs 6.3 IU/l in the others) and of uncertain biological significance. During the luteal phase, no differences between any of the groups in LH and FSH concentrations were found.

Polycystic Ovary Syndrome: A Changing Perspective

“…It is possible that women with PCO who have ovulatory cycles form a separate group with a different aetiology from those who have anovulatory cycles and high LH. But a marked reduction of LH can also be observed during both spontaneous and induced ovulatory cycles in the latter group (Baird et al, 1977;Abdulwahid et al, 1985;Polson et al, 1987a) (Fig. 4).…”

Hypersecretion of luteinising hormone: a significant cause of infertility and miscarriage

“…In patients with amenorrhoea undergoing treatment with pulsatile luteinising hormone releasing hormone (LHRH) for induction of ovulation, follicular phase plasma LH concentrations were significantly higher in those with the polycystic ovary syndrome than in those with other diagnoses (Abdulwahid et al 1985). In an extension of this study, it was found that the miscarriage rate was 33% in women with PCOS compared with 10.6% in those with hypogonadotrophic hypogonadism (Homburg et al 1988).…”

Influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in polycystic ovary syndrome

“…This disappointing outcome is in direct contrast to the excellent results obtained with the same treatment in patients with hypogonadotrophic hypogonadism.l Patients with the polycystic ovary syndrome often have raised basal concentrations of luteinising hormone,2 and we have shown that, when ovulation is induced with pulsatile luteinising hormone releasing hormone, luteinising hormone concentrations often remain high throughout the follicular phase. 3 In this study we measured luteinising hormone concentrations in patients with the polycystic ovary syndrome being treated with pulsatile luteinising hormone releasing hormone and related them to whether or not ovulation and conception occurred and to the fate of the pregnancy. We have reported the clinical results in 48 of the patients elsewhere.4…”