Response to clomiphene citrate in the polycystic ovarian syndrome according to different LH/FSH ratios

Twenty-nine clomiphene tests were carried out, 19 on subjectswith polycystic ovarian syndrome (PCO) who did not wish to conceiveand 10 on women with correct ovarian function (control women).The intention was to determine if the response of the hypothalamic—pituitary—ovaryaxis varies according to different LH/FSH ratios. The resultsindicate that with repeated LH/FSH ratios of <3, the positiveand negative feedback systems are preserved in most subjects,but when the ratio is higher than 3, both systems are significntlyaltered (P < 0.01). In the control group, both systems werepreserved in all subjects. In another group composed of 26 infertilepatients with PCO, the rate of ovulation and pregnancy afteradministration of clomiphene citrate (CC) was correlated accordingto different LH/FSH ratios. A significant (P < 0.0001) redudonin the rate of ovulation and a lesser reduction in pregnancywas found with increasing LH/FSH ratios. In conclusion we suggestthat the LH/FSH ratio is a good marker of this syndrome, andcan be used to give a prognosis on the severity of the syndrome,as well as the ovulatory capacity of the subject after administrationof CC.