title: Dynamics of bioactive follicle-stimulating hormone secretion in women with polycystic ovary syndrome: effects of estradiol and progesterone.
abstract: OBJECTIVE
  To determine the nature of bioactive FSH secretion in anovulatory women with polycystic ovary syndrome (PCOS) and its modulation by luteal levels of E2 and P.
  
  
  METHODS
  Interventional and observational study.
  
  
  METHODS
  Academic clinical research center.
  
  
  METHODS
  Five patients with PCOS.
  
  
  METHODS
  Treatment for 21 days with luteal levels of E2 and P.
  
  
  METHODS
  Serum levels of immunoreactive LH, immunoreactive FSH, bioreactive FSH, and the FSH isoform distribution pattern. Blood was sampled frequently and GnRH testing was done on day 0 (before treatment), days 10 and 20 (during treatment), and day 28 (7 days after treatment).
  
  
  RESULTS
  Treatment with E2 and P suppressed circulating immunoreactive LH and immunoreactive FSH but not bioreactive FSH. Anovulatory women with PCOS showed a predominantly acidic pattern of FSH isoform distribution. Treatment with E2 and P shifted the distribution profile of FSH isoforms to the less acidic. After cessation of E2-P treatment, FSH reverted to its pretreatment pattern of distribution.
  
  
  CONCLUSIONS
  Resumption of follicular growth after luteal replacement of E2 and P in anovulatory women with PCOS may be related to the reduction in the elevated LH/FSH ratio and accompanying changes in the FSH signal.
authors.affiliation: Department of Pediatrics, University of Michigan, Ann Arbor, Michigan 48109-0404, USA. vansantha@umich.edu
authors.forename: V
authors.initials: V
authors.lastname: Padmanabhan
authors.forename: G M
authors.initials: GM
authors.lastname: Christman
authors.forename: J F
authors.initials: JF
authors.lastname: Randolph
authors.forename: R P
authors.initials: RP
authors.lastname: Kelch
authors.forename: J C
authors.initials: JC
authors.lastname: Marshall
authors.forename: I Z
authors.initials: IZ
authors.lastname: Beitins
mesh_terms: D000735:Androstenedione / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood / Q000378:metabolism*; D007987:Gonadotropin-Releasing Hormone / Q000494:pharmacology; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000187:drug effects* / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000378:metabolism; D011374:Progesterone / Q000008:administration & dosage / Q000494:pharmacology*; D020033:Protein Isoforms; D013739:Testosterone / Q000097:blood
chemical_list: D020033:Protein Isoforms; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D000735:Androstenedione; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone