Pituitary-ovarian axis in women with chronic renal failure undergoing regular hemodialysis

ABSTRACT

The pathogenesis of ovarian dysfunction was studied in ten [10] female patients with chronic renal failure treated with regular hemodialysis. Their ages ranged from 20 to 37 years. Another ten [10] healthy adult females served as controls, their ages ranged from 23 to 35 years. Assessment of follicle stimulating hormone [FSH], leuteinzing hormone [LH], prolactin and estradiol in serum was done. Clomiphene stimulation test to FSH and LH was also done in a random group of 7 dialyzed patients. Serum FSH, LH and estradiol in dialyzed patients were comparable to those found in normal women during the follicular phase of the menstrual cycle. In all patients, there was an absence of cyclicity. After clomiphene, serum levels of LH and FSH rose significantly suggesting that the negative estradiol feedback, the tonic gonadotropin secretion and the pituitary avarian axis were normal. The positive estradiol feedback associated with cyclic release of lureinizing hormone was impaired as indicated by the prevalence of acyclicity and absence of ovulation. Hyperprolactinaemia in dialyzed group may inhibit ovarian function at multiple levels along hypothalamic pituitary ovarian axis