[A possible role of ultrasound-guided follicular aspiration in induction of ovulation in patients with polycystic ovaries].
To investigate a possible role of ultrasound-guided follicular aspiration in the induction of ovulation in patients with polycystic ovaries (PCO). Serum concentrations of immunoreactive LH (I-LH), bioactive LH (B-LH), FSH, androstenedione, testosterone (T), dehydroepiandrosterone sulfate, E1, E2, and progesterone before and after the follicular aspiration were examined. Follicular aspiration was carried out 7 days after hCG administration in twelve patients refractory to ovulation induction with clomiphene-hMG-hCG. Concentrations (mean +/- SEM) of I-LH, B-LH, and T on day 3 of the menstrual cycle after the aspiration were significantly lower than those before the aspiration (4.8 +/- 0.5 vs 12.6 +/- 1.0 mIU/mL, 18.1 +/- 2.1 vs 50.0 +/- 4.1 mIU/mL, 45.4 +/- 5.0 vs 60.8 +/- 7.1 ng/dl, respectively; p < 0.01). The pattern of LH secretion in response to GnRH challenge test was also normalized after the aspiration. A significant decline in serum levels of E2 and T (p < 0.001) was observed 2h after the aspiration. The ovulation rate was 83.3% (10/12), and one patient achieved pregnancy after the aspiration. The present study suggests that an acute decline in serum levels of ovarian steroids after the aspiration possibly acted on the hypothalamo-pituitary axis of the patients to normalize sensitivity, and the treatment could release the patients from an endocrinologically-mediated vicious cycle and result in the achievement of ovulation.
Katagiri
C
C
Department of Obstetrics and Gynecology, Tottori University, Faculty of Medicine, Yonago.
D000328:Adult; D000735:Androstenedione / Q000097:blood; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D015571:Follicular Fluid; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology* / Q000628:therapy; D011374:Progesterone / Q000097:blood; D013396:Suction; D013739:Testosterone / Q000097:blood
D004970:Estrone; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone