title: Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria.
abstract: OBJECTIVE
  As increased frequency of gonadotrophin-releasing hormone (GnRH) pulses is characteristic for polycystic ovary syndrome (PCOS), we assessed gonadotrophin response to GnRH in women with PCOS with normal and raised androgens and in regularly menstruating controls.
  
  
  METHODS
  The study involved 155 subjects: PCOS, n=121, age (mean±SD) 24.8±5.4 yrs, BMI 24.5±6.0 kg/m2, all with oligo-/amenorrhoea and PCO morphology, and 34 controls. Gonadotrophins were measured in early follicular phase after GnRH stimulation (0, 30 and 60 minutes).
  
  
  RESULTS
  Fifty four (41.9%) women with PCOS had androgens (testosterone, androstendione, dihydroepiandrosterone sulphate) within the reference range, and would fulfil the "Rotterdam", but not the Androgen Excess Society PCOS criteria. Baseline and stimulated LH concentrations were higher in PCOS (9.09±5.56 vs 4.83±1.71 IU/l, 35.48±31.4 vs 16.30±6.68 IU/l, 33.86±31.8 vs 13.45±5.2 IU/l, at 0, 30 and 60 min post GnRH, respectively, p<0.0001). An LH/FSH ratio in PCOS increased further after GnRH stimulation. ROC analysis revealed that LH30min/FSH30min >2.11 or LH60min/FSH60min >1.72 had 78.3% and 87.5% sensitivity and 81.7% and 81.3% specificity for diagnosis of PCOS. Both baseline and GnRH-stimulated LH and FSH concentrations were similar in women with PCOS and raised androgens and with androgens within the reference range (p=0.71 and p=0.20 for LH and FSH, respectively).
  
  
  CONCLUSIONS
  Regardless of their androgen status, women with PCO morphology and oligo-/amenorrhoea have higher baseline and GnRH-stimulated LH concentrations and higher GnRH-stimulated LH/FSH ratio than controls, suggestive of similar underlying mechanism accounting for menstrual irregularities. These observations support validity of PCOS diagnostic criteria based on the Rotterdam consensus.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland.
authors.forename: Krzysztof C
authors.initials: KC
authors.lastname: Lewandowski
authors.forename: Agata
authors.initials: A
authors.lastname: Cajdler-Luba
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Bieńkiewicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Lewiński
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000097:blood* / Q000503:physiopathology; D000728:Androgens / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D009839:Oligomenorrhea / Q000097:blood* / Q000503:physiopathology; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D012372:ROC Curve; D055815:Young Adult
chemical_list: D000728:Androgens; D001786:Blood Glucose; D007328:Insulin; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone