Response to clomiphene citrate in the polycystic ovarian syndrome according to different LH/FSH ratios

Abstract

Twenty-nine clomiphene tests were carried out, 19 on subjects with polycystic ovarian syndrome (PCO) who did not wish to conceive and 10 on women with correct ovarian function (control women). The intention was to determine if the response of the hypothalamic-pituitary-ovary axis varies according to different LH/FSH ratios. The results indicate that with repeated LH/FSH ratios of less than 3, the positive and negative feedback systems are preserved in most subjects, but when the ratio is higher than 3, both systems are significantly altered (P less than 0.01). In the control group, both systems were preserved in all subjects. In another group composed of 26 infertile patients with PCO, the rate of ovulation and pregnancy after administration of clomiphene citrate (CC) was correlated according to different LH/FSH ratios. A significant (P less than 0.0001) reduction in the rate of ovulation and a lesser reduction in pregnancy was found with increasing LH/FSH ratios. In conclusion we suggest that the LH/FSH ratio is a good marker of this syndrome, and can be used to give a prognosis on the severity of the syndrome, as well as the ovulatory capacity of the subject after administration of CC.

Ο ωοθηκικός έλεγχος της υποφυσιακής ευαισθησίας στη GnRH στις γυναίκες με PCOS

“…Αυτά τα ευρήµατα εξηγούν γιατί οι αδύνατες ανωορρηκτικές γυναίκες (που έχουν κυρίως ωοθηκική Ε2), πάνε καλά µε θεραπείες που ελαττώνουν την ωοθηκική Ε2 όπως ο ωοθηκικός καυτηριασµός (Greenblatt and Casper, 1987;Gjonnaess, 1994;Duleba et al,2003;Amer et al, 2004), ενώ οι παχύσαρκες ανωορρηκτικές γυναίκες ( µε περιφερική παραγωγή Ε2) συνήθως πάνε καλύτερα µε θεραπείες που αυξάνουν την FSH µέσω γοναδοτροφινών (Vicino et al, 2000) ή µέσω κλοµιφένης (Lopez-Lopez et al, 1987;Ficicioglu et al, 1996) και αυτό δε σχετίζεται µε αυξηµένη παραγωγή προγεστερόνης (Judd et al,1992) αλλά µε υπερίσχυση της FSH στην Ε2.…”