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The concentrations and the pattern of gonadotropin secretion were determined in 16 patients with documented polycystic ovarian disease (PCO). Sequential measurements of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in serum by specific radioimmunoassays were made. The data showed that the mean LH concentrations in patients with PCO were consistently and significantly higher than the mean LH concentration observed during the follicular phase of the normal cycle. There was random fluctuation. By contrast, the mean serum FSH concentrations were remarkably constant and were significantly lower than the mean FSH concentrations observed during the early follicular phase, but comparable to the levels of FSH during the late follicular phase of the normal cycle. The daily concentrations of LH in individual patients were highly variable. Likewise, the pattern of LH secretion varied markedly from patient to patient. In general, the serum LH pattern was that of an erratic fluctuation with a high base line. The frequent small burst of LH secretion was not accompanied by the changes in FSH or progesterone concentrations. Thus, in patients with PCO, the cyclic pattern of FSH and LH secretion was typically absent and there was a disproportionately high LH secretion with constant low FSH secretion. These findings are consistent with the concept that a disturbance in the hypothalamic regulation of gonadotropin secretions may be causally related to the chronic anovulation and abnormal steroidogenesis in patients with PCO.
YEN et al. (Wed,) studied this question.