Recovery of hormone secretion after chronic gonadotropin-releasing hormone agonist administration in women with polycystic ovarian disease

Détails

ID Serval
serval:BIB_04971D7048E3
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Recovery of hormone secretion after chronic gonadotropin-releasing hormone agonist administration in women with polycystic ovarian disease
Périodique
Journal of Clinical Endocrinology and Metabolism
Auteur⸱e⸱s
de Ziegler  D., Steingold  K., Cedars  M., Lu  J. K., Meldrum  D. R., Judd  H. L., Chang  R. J.
ISSN
0021-972X
Statut éditorial
Publié
Date de publication
06/1989
Peer-reviewed
Oui
Volume
68
Numéro
6
Pages
1111-7
Notes
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S. --- Old month value: Jun
Résumé
Persistent suppression of gonadotropin and ovarian steroid production can be achieved in women with polycystic ovarian disease (PCO) by daily administration of a long-acting GnRH agonist (GnRHa). This study was designed to determine the patterns of recovery of clinical responses and hormonal secretion after chronic GnRHa administration in women with PCO. Six women with PCO were treated with daily sc injections of [D-His6(imBzl),Pro9-NEt]GnRHa (100 micrograms) for 6 months. Blood samples were obtained at the time of and three times weakly for 90 days after discontinuation of agonist therapy. In five women who did not ovulate, the suppressed serum FSH levels rose to pretreatment values within 10 days. In contrast, a gradual and progressive increase in serum LH (as measured by bioassay and immunoassay) was apparent by day 18. The LH increase coincided with progressive increases in serum estrone (E1), androstenedione, and testosterone. Serum estradiol (E2) began to rise on day 28. All hormones returned to their pretreatment baseline values within the 90-day recovery interval, with the exception of E2. Trend analysis of the slopes of recovery revealed that the incremental secretion patterns of E1, E2, androstenedione, and testosterone differed significantly from that of FSH, but not from those of bioactive or immunoactive LH. Serum progesterone, dehydroepiandrosterone sulfate, and cortisol did not change after withdrawal of GnRHa. One woman ovulated spontaneously on day 52 before which her hormone secretion patterns were indistinguishable from those of the other women. In summary, 1) during recovery after discontinuation of chronic GnRH agonist therapy the patterns of FSH and LH release suggested resumption of endogenous GnRH action on the pituitary with greater release of FSH than LH, a pattern that would be expected in the absence of ovarian steroid influence; 2) the lack of early estrogen production despite the increase in serum FSH concentrations suggests inadequate FSH secretion, abnormal ovarian responsiveness to FSH, or impaired FSH bioactivity; 3) androgen secretion was provoked by the increase in LH secretion; 4) per unit LH measured by bioassay, greater ovarian androgen secretion was stimulated in PCO than ovulatory women; and 5) the likelihood of spontaneous ovulation during recovery was minimal.
Mots-clé
Adult Dehydroepiandrosterone/blood/secretion Delayed-Action Preparations/administration & dosage Estradiol/blood/secretion Estrone/blood/secretion Female Follicle Stimulating Hormone/blood/secretion Gonadotropin-Releasing Hormone/*antagonists & inhibitors Gonadotropins, Pituitary/*blood/secretion Humans Hydrocortisone/blood/secretion Luteinizing Hormone/blood/secretion Ovary/*physiology Ovulation Pituitary Hormone-Releasing Hormones/*administration & dosage/pharmacokinetics Polycystic Ovary Syndrome/*blood Progesterone/blood/secretion Steroids/biosynthesis
Pubmed
Web of science
Création de la notice
28/02/2008 11:37
Dernière modification de la notice
20/08/2019 12:26
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