title: Influence of ovarian manipulation on reproductive endocrinology in polycystic ovarian syndrome and regularly cycling women.
abstract: OBJECTIVE
  Little is known about the function of the ovarian neuronal network in humans. In many species, copulation influences endocrinology through this network. As a first step, the possible influence of ovarian mechanical manipulation on pituitary and ovarian hormones was evaluated in polycystic ovarian syndrome (PCOS) and regularly cycling women.
  
  
  METHODS
  Prospective case-control study (2008-2010).
  
  
  METHODS
  Ten PCOS women (Rotterdam criteria) undergoing ovulation induction with recombinant-FSH and ten normal ovulatory controls were included in an academic fertility clinic. In the late follicular phase blood was drawn every 10 min for 6 h. After 3 h the ovaries were mechanically manipulated by moving a transvaginal ultrasound probe firmly over each ovary ten times. Main outcome measures were LH and FSH pulsatility and ovarian hormones before and after ovarian manipulation.
  
  
  RESULTS
  All PCOS patients showed an LH decline after the ovarian manipulation (before 13.0 U/l and after 10.4 U/l, P<0.01), probably based on a combination of a longer LH pulse interval and smaller amplitude (P=0.07). The controls showed no LH change (before 9.6 U/l and after 9.3 U/l, P=0.67). None of the ovarian hormones (estradiol, progesterone, anti-Müllerian hormone, inhibin B, androstenedione and testosterone) changed in either group.
  
  
  CONCLUSIONS
  Ovarian mechanical manipulation lowers LH secretion immediately and typically only in preovulatory PCOS patients. The immediate LH change after the ovarian manipulation without any accompanying ovarian hormonal changes point to nonhormonal communication from the ovaries to the pituitary. A neuronal pathway from the ovaries communicating to the hypothalamic-pituitary system is the most reasonable explanation.
authors.affiliation: Division of Reproductive Medicine, Department of Obstetrics and Gynecology.
authors.forename: M L
authors.initials: ML
authors.lastname: Hendriks
authors.forename: T
authors.initials: T
authors.lastname: König
authors.forename: R S
authors.initials: RS
authors.lastname: Soleman
authors.forename: T
authors.initials: T
authors.lastname: Korsen
authors.forename: R
authors.initials: R
authors.lastname: Schats
authors.forename: P G A
authors.initials: PG
authors.lastname: Hompes
authors.forename: R
authors.initials: R
authors.lastname: Homburg
authors.forename: C B
authors.initials: CB
authors.lastname: Lambalk
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005298:Fertility / Q000502:physiology*; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D005498:Follicular Phase / Q000502:physiology; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000502:physiology*; D010060:Ovulation / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D013314:Stress, Mechanical
chemical_list: D043373:Follicle Stimulating Hormone, Human; D012739:Gonadal Steroid Hormones; D007986:Luteinizing Hormone