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Obstetrics & Gynecology 1976;47:388-394
© 1976 by The American College of Obstetricians and Gynecologists
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Clinical Findings and Hormonal Responses in Patients With Polycystic Ovarian Disease With Normal Versus Elevated LH Levels

JAMES R. GIVENS, MD, RICHARD N. ANDERSEN, PhD, EDWARD S. UMSTOT, BS and WINFRED L. WISER, MD, FACOG

From the Division of Reproductive Medicine. Department of Obstetrics and Gynecology at The University of Tennessee Center for the Health Sciences. Memphis. Tennessee

Abstract

The clinical features, ovarian pathology, and hormonal responses to dexamelhasone (Dex), Dex + clhinyl cstradiol (HE), and Dex + hCG were compared in 5 women with polycyslic ovarian disease (PCOD) who have normal 24-hr urinary luteinizing hormone (LH) levels to 5 who had elevated urinary LH levels. No differences were noted in the clinical features. There was no correlation between ovary size and LH levels. Three in the normal-LH group had hyperthecosis. Plasma androstenedione (A) was more frequently elevated in the high- LH group. Dex + EE markedly increased LH secretion in the high-LH group, suggesting increased responsiveness of the positive feedback control mechanism of LH secretion in the high-LH group. There was a greater response of A, testosterone (T), and 17-ketosteroids to Dex + hCG in the normal-LH group. Those with high-LH levels did not exhibit a significant increase in A, T, and 17-KS with hCG. The limitations and usefulness of the Dex -r hCG test are discussed. The hypothesis is advanced that the increased LH secretion in the high-LH group is due at least in part to positive feedback resulting from the increased A levels. The amount of 17ß-oxidoreductasc activity in the ovary may influence LH secretion in PCOD.




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