Gonadotropin and Ovarian Steroid Production in Polycystic Ovarian Syndrome during Suppression with a Gonadotropin-Releasing Hormone Agonist

Abstract

Six women with polycystic ovarian syndrome were treated with a gonadotropin-releasing hormone agonist prior to ovulation induction with gonadotropins. Buserelin nasal spray (600 µg/day) was given for 6 weeks. There was a gradual and significant decrease in the level of luteinizing hormone (LH) during the treatment period. No change was observed in the level of follicle-stimulating hormone. The estradiol, estrone, testosterone and androstenedione levels decreased significantly. No reduction was seen in the DHEAS level. After 4 weeks of treatment LH had reached postmenopausal levels, and testosterone and androstenedione were within the normal range. It is concluded that 4 weeks’ treatment with 600 µg buserelin intranasally per day is sufficient to normalize the ovarian androgen production in polycystic ovarian syndrome prior to gonadotropin stimulation and to reduce the LH level avoiding premature luteinization or spontaneous LH surge.

Assisted Fertilization

“…If this was also the case in PCOS, a decrease in the LH level would be expected to reduce the ovarian androgen production and thereby decrease the process of atresia. G n R H agonist administration to 6 women with PCOS reduced the serum levels of LH, testosterone and androstenedione significantly (4). The time needed to suppress pituitary LH release, Acto Ohsrrr Gynecol Scund 71 (1992) Assisted fertilization 87 however, was longer in PCOS patients than usually needed in ovulatory women.…”