Circulating immunoreactive and bioactive follicle stimulating hormone concentrations in anovulatory infertile women and during gonadotrophin induction of ovulation using a decremental dose regimen |
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| Authors: | van Dessel, H.J.H.M.Thierry Schoot, Benedictus C. Schipper, Izaak Dahl, Kris D. Fauser, Bart C.J.M. |
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| Affiliation: | 1 Section of Reproductive Endocrinology and Fertility, Department of Obstetrics and Gynaecology, Dijkzigt Academic Hospital and Erasmus University, Dr. Molewaterplein 40 3015 GD Rotterdam, The Netherlands 2 Department of Medicine, Veterans Administration Medical Center Seattle, WA 98108, USA |
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| Abstract: | Our purpose was to determine whether decreased follicle stimulatinghormone (FSH) activity, either systemic or at the follicularlevel, is involved in impaired follicle growth associated withnormogonadotrophic anovulation. To differentiate between thepossible levels of disturbance, bioactive (BIO-FSH; using thein-vitro rat granulosa cell aromatase bioassay) and immunoreactive(IRMA-FSH) FSH serum concentrations of three groups of subjectswere compared: (i) 172 normogonadotrophic anovulatory infertilewomen during baseline conditions, (ii) 22 clomi-phene-resistantpolycystic ovary syndrome patients undergoing ovulation inductionby exogenous gonadotrophins using a decremental dose regimen,and (iii) nine regularly cycling controls. BIO-FSH [13.2 (range0.8–29.5) IU/1] and IRMA-FSH [4.4 (range 1.2–9.3)IU/1] concentrations in anovulatory women during baseline conditionswere significantly lower than maximum concentrations reachedduring the follicular phase in controls [18.7 (13.2–23.4)and 6.4 (5.7–10.0) IU/1 respectively], but were not significantlydifferent from initial concentrations in controls [10.4 (7.2–19.6)and 4.8 (2.8–8.2) IU/1 respectively]. Moreover, concentrationsof IRMA-FSH and BIO-FSH were negatively correlated (r = –0.25,P = 0.01, and r = –0.24, P = 0.02 respectively) with theinterval between last vaginal bleeding and blood sampling. Maximumconcentrations of IRMA-FSH [7.6 (3.9–10.9) IU/1] duringovulation induction by gonadotrophins were not significantlydifferent from [6.4 (5.7–10.0) IU/1] concentrations incontrols, whereas maximum BIO-FSH concentrations [13.5 (8.7–17.4)versus 18.7 (13.2–23.4) IU/1] were significantly lower.Our findings suggest that (i) circulating FSH does not reachconcentrations that are sufficient to induce normal follicledevelopment in anovulatory women during base-line conditions,and (ii) the FSH threshold for ovarian stimulation of this patientgroup is not different from normal |
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| Keywords: | anovulation/FSH/gonadotrophins/hyperandro-genemia/polycystic ovary syndrome |
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