Increase in androgen:estrogen ratio specifically during low-dose follicle-stimulating hormone therapy for polycystic ovary syndrome.
OBJECTIVE
To compare changes in serum androgens in women with polycystic ovary syndrome (PCOS) during ovulation induction with low-dose versus conventional urofollitropin.


METHODS
Prospective case-control study.


METHODS
Tertiary-care reproductive medicine center.


METHODS
Thirty-three women with PCOS who failed to conceive with clomiphene citrate therapy.


METHODS
Urofollitropin (low-dose, 75 IU; conventional dose, 150 IU) was administered IM daily. Therapy was monitored by serum E2 and vaginal sonography. Hormone determinations were performed by immunoassay.


METHODS
Serum E2, androstenedione (A), T, and LH levels.


RESULTS
On the day of hCG administration, patients treated with low-dose therapy exhibited significantly higher ratios of A to E2 (3.5 +/- 0.5 versus 2.2 +/- 0.3 [mean +/- SEM]) and T to E2 (1.5 +/- 0.3 versus 1.0 +/- 0.1) compared with conventional urofollitropin therapy. The number of follicles > or = 16 mm in diameter was significantly lower with low-dose therapy (2.7 +/- 0.6 versus 5.4 +/- 0.4).


CONCLUSIONS
Although low-dose therapy was associated with a reduction in the number of recruited follicles, the increase in androgen to E2 associated with this therapy may adversely affect oocyte quality and may explain the relatively high miscarriage rate reported in PCOS patients with this therapy.
Brzyski
R G
RG
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, USA.
Grow
D R
DR
Sims
J A
JA
Seltman
H J
HJ
D000328:Adult; D000728:Androgens / Q000097:blood*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D004967:Estrogens / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000188:drug therapy*; D011446:Prospective Studies
D000728:Androgens; D004967:Estrogens; D005640:Follicle Stimulating Hormone