Administration of L-thyroxine does not improve the response of the hypothalamo-pituitary-ovarian axis to clomiphene citrate in functional hypothalamic amenorrhea.
OBJECTIVE
To investigate the hypothalamo-pituitary-ovarian axis in women with functional hypothalamic amenorrhea to determine whether the combination of L-thyroxine and clomiphene citrate produces a qualitative and quantitative increase in induced ovulatory cycles.


METHODS
Gynecological Endocrinology Research Center, University of Siena (Italy).


METHODS
16 young women with functional hypothalamic amenorrhea and 15 women with normal cycles in early follicular phase.


METHODS
Administration of 50 microgram GnRH and 200 microgram TRH. The women with functional hypothalamic amenorrhea were divided into groups A (n=8) and B (n=8). Both groups were given 100 mg/day clomiphene for 5 days/month for 3 months. Women in group A were also given 75 mcg/day thyroid hormone (L-thyroxine) for 3 months.


METHODS
Comparison of basal and stimulated levels of gonadotropins, TSH and Prl, in groups A and B. Qualitative and quantitative comparison of ovulatory cycles induced in the groups.


RESULTS
Administration of clomiphene and clomiphene plus L-thyroxine was evaluated in the second and third months of treatment and was followed by a total of 11 ovulatory cycles, six in group A and five in group B. No significant difference was found between groups. Mean progesterone concentrations measured 16 days after the last clomiphene tablet were 5.5+/-1.2 ng/ml in group A and 5.1+/-1.3 ngl/ml in group B.


CONCLUSIONS
Administration of L-thyroxine with clomiphene does not improve the response of the hypothalamo-pituitary-ovarian axis to clomiphene citrate or the number of ovulatory cycles and does not reduce luteal phase defects.
De Leo
V
V
Department of Obstetrics and Gynecology, Policlinico Le Scotte, University of Siena, Viale Bracci, 53100, Siena, Italy. deleo@unisi.it
la Marca
A
A
Lanzetta
D
D
Morgante
G
G
D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy*; D016022:Case-Control Studies; D002996:Clomiphene / Q000494:pharmacology*; D004965:Estrogen Antagonists / Q000494:pharmacology; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology; D006728:Hormones / Q000097:blood; D006801:Humans; D007031:Hypothalamus / Q000187:drug effects* / Q000502:physiology; D007986:Luteinizing Hormone / Q000097:blood / Q000494:pharmacology; D010053:Ovary / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects* / Q000502:physiology; D012016:Reference Values; D013974:Thyroxine / Q000494:pharmacology*
D004965:Estrogen Antagonists; D006728:Hormones; D002996:Clomiphene; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D013974:Thyroxine