Effects of gonadotropin-releasing hormone (GnRH) agonist on pituitary and ovarian responses to pulsatile GnRH therapy in polycystic ovarian disease.
Nine clomiphene citrate-resistant polycystic ovarian disease (PCOD) patients received intravenous gonadotropin-releasing hormone (GnRH) pulses before and immediately after 1 month of GnRH agonist (GnRH-a) therapy. Circulating gonadotropin and ovarian steroid levels, as well as follicular development, were measured throughout therapy. Results were compared with those obtained from five hypogonadotropic patients treated with GnRH pulses only who ovulated during six of seven treatment cycles. Only two PCOD patients ovulated normally with GnRH pulses before GnRH-a therapy. Aberrant gonadotropin and ovarian steroid secretory patterns were noted in the others. After GnRH-a, gonadotropin and ovarian steroid hormone levels were similar to those of the hypogonadotropic patients. Subsequent secretory responses to GnRH pulses were partially normalized. However, only two additional PCOD patients ovulated.
Surrey
E S
ES
Cedars-Sinai Medical Center, Los Angeles, California 90048.
de Ziegler
D
D
Lu
J K
JK
Chang
R J
RJ
Judd
H L
HL
D000568:Amenorrhea / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006062:Gonadotropins / Q000097:blood; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications; D010053:Ovary / Q000187:drug effects*; D010902:Pituitary Gland / Q000187:drug effects*; D010906:Pituitary Hormone-Releasing Hormones / Q000494:pharmacology / Q000627:therapeutic use*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy*; D011247:Pregnancy; D011673:Pulsatile Flow
D012739:Gonadal Steroid Hormones; D006062:Gonadotropins; D010906:Pituitary Hormone-Releasing Hormones