Multiple follicles in an unstimulated cycle despite elevated gonadotropins in a perimenopausal female.
The presence of estrogen deficiency associated with elevated gonadotropins usually signifies menopause. However, there have been a few case reports of ovulation and pregnancy despite hypergonadotropic hypogonadism. Described herein is a case of a perimenopausal woman who not only failed to ovulate in response to clomiphene citrate therapy but also failed to generate a level of serum estradiol (E2) over 30 pg/ml. Following pharmacologic suppression of her elevated gonadotropins with ethinyl estradiol, she spontaneously formed 3 mature follicles, and her serum E2 climbed to 868 pg/ml. This case suggests that some perimenopausal women may respond to their own endogenous elevated gonadotropins as if they are taking ovulation-inducing drugs and may, as a consequence, form multiple follicles.
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J H
JH
University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, Camden.
D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007247:Infertility, Female; D007986:Luteinizing Hormone / Q000097:blood*; D008593:Menopause; D008597:Menstrual Cycle; D006080:Ovarian Follicle; D010062:Ovulation Induction
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone