Polycystic ovaries: do these represent a specific endocrinopathy?

Serum pituitary gonadotrophins, oestradiol, testosterone and insulin pulse patterns were examined at 15-min intervals for 6 h in 40 women with a previous diagnosis of polycystic ovarian disease (PCO) based on clinical, endocrinological and ultrasound data. Age, duration of symptoms, body mass index (BMI) and ovarian volume showed no correlation with the 6-h mean value of any hormone and testosterone blood levels did not correlate with those of insulin. Some patients had high and others low LH pulse pattern components, and few had an inverted LH:FSH ratio. Morphological polycystic ovarian changes may be a reflection of various rather than a single pattern of gonadotrophin secretion.

Hormonal changes in patients with polycystic ovarian disease after ovarian electrocautery or pituitary desensitization.

Eleven patients with polycystic ovarian disease (PCO) were treated by laparoscopic ovarian electrocautery and nine with a long-acting luteinizing hormone releasing agonist (LHRH-A) for 8 weeks. Both groups showed equivalent significant decreases in their 6-h mean values of luteinizing hormone (LH) and testosterone (T) measured in 25 samples collected every 15 min. Patients treated with ovarian electrocautery showed significant increases in their 6-h mean values of follicle stimulating hormone (FSH) and insulin with variable oestradiol (E2) responses. The magnitude of change following treatment was significantly greater for LH than for FSH. Buserelin medication did not cause persistent significant changes in the levels of insulin or FSH but it did cause a significant reduction in the 6-h mean values of E2. We conclude that LH is the gonadotrophin primarily affected after pituitary desensitization and ovarian electrocautery. Furthermore, there is no direct correlation between the levels of circulating insulin and testosterone in patients with PCO.