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Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma.
Clin Endocrinol (Oxf). 2006 Sep; 65(3):396-401.CE

Abstract

OBJECTIVE

To evaluate the influence of ovarian stroma on basal and poststimulus androgen secretion in patients affected by secondary amenorrhoea and polycystic ovaries (PCO) at ultrasound (US).

DESIGN

Prospective study.

PATIENTS

Fifty-one patients with PCO selected from a group of 72 normal weight women aged 20-25 years affected by secondary amenorrhoea and 10 normal ovulatory controls.

METHODS

All subjects underwent US to evaluate volume, area, stromal area and stromal/total area ratio of both ovaries. Plasma levels of gonadotrophins, oestradiol (E2) and androgens were measured before and 24 h after GnRH-a injection. 60 min after stimulus LH and FSH were also assayed.

RESULTS

Thirty patients had increased ovarian stroma (IS) and 21 patients normal ovarian stroma (NS). Significantly higher LH levels characterized the IS group, both basally and after GnRH-a stimulation compared with NS and controls (P < 0.01). Baseline levels of androstenedione, testosterone and 17-OHprogesterone (17-OHP) were significantly higher in IS group. Moreover, 17-OHP hyper-response to GnRH-a was demonstrated in IS group in comparison to NS and control groups (P < 0.005).

CONCLUSIONS

Stroma evaluation may be of use in discriminating between different pathogenic factors in secondary amenorrhoea. This criterion may be applied to support the correct diagnosis of polycystic ovary syndrome (PCOS). Indeed, in line with the most recently proposed guidelines, patients affected by multifollicular ovaries could be classified as PCOS. The possibility of taking into account more than one US criterion or of carefully reanalysing the significance of increased stroma volume should be considered.

Authors+Show Affiliations

Dipartimento Chirurgico Materno-Infantile e di Scienze delle Immagini, Università degli Studi di Cagliari, Cagliari, Italy. fulgh@tiscalinet.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16918963

Citation

Fulghesu, A M., et al. "Pituitary-ovarian Response to the Gonadotrophin-releasing Hormone-agonist Test in Anovulatory Patients With Polycystic Ovary Syndrome: Predictive Role of Ovarian Stroma." Clinical Endocrinology, vol. 65, no. 3, 2006, pp. 396-401.
Fulghesu AM, Angioni S, Belosi C, et al. Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma. Clin Endocrinol (Oxf). 2006;65(3):396-401.
Fulghesu, A. M., Angioni, S., Belosi, C., Apa, R., Selvaggi, L., Ciampelli, M., Iuculano, A., Melis, G. B., & Lanzone, A. (2006). Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma. Clinical Endocrinology, 65(3), 396-401.
Fulghesu AM, et al. Pituitary-ovarian Response to the Gonadotrophin-releasing Hormone-agonist Test in Anovulatory Patients With Polycystic Ovary Syndrome: Predictive Role of Ovarian Stroma. Clin Endocrinol (Oxf). 2006;65(3):396-401. PubMed PMID: 16918963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma. AU - Fulghesu,A M, AU - Angioni,S, AU - Belosi,C, AU - Apa,R, AU - Selvaggi,L, AU - Ciampelli,M, AU - Iuculano,A, AU - Melis,G B, AU - Lanzone,A, PY - 2006/8/22/pubmed PY - 2007/1/16/medline PY - 2006/8/22/entrez SP - 396 EP - 401 JF - Clinical endocrinology JO - Clin Endocrinol (Oxf) VL - 65 IS - 3 N2 - OBJECTIVE: To evaluate the influence of ovarian stroma on basal and poststimulus androgen secretion in patients affected by secondary amenorrhoea and polycystic ovaries (PCO) at ultrasound (US). DESIGN: Prospective study. PATIENTS: Fifty-one patients with PCO selected from a group of 72 normal weight women aged 20-25 years affected by secondary amenorrhoea and 10 normal ovulatory controls. METHODS: All subjects underwent US to evaluate volume, area, stromal area and stromal/total area ratio of both ovaries. Plasma levels of gonadotrophins, oestradiol (E2) and androgens were measured before and 24 h after GnRH-a injection. 60 min after stimulus LH and FSH were also assayed. RESULTS: Thirty patients had increased ovarian stroma (IS) and 21 patients normal ovarian stroma (NS). Significantly higher LH levels characterized the IS group, both basally and after GnRH-a stimulation compared with NS and controls (P < 0.01). Baseline levels of androstenedione, testosterone and 17-OHprogesterone (17-OHP) were significantly higher in IS group. Moreover, 17-OHP hyper-response to GnRH-a was demonstrated in IS group in comparison to NS and control groups (P < 0.005). CONCLUSIONS: Stroma evaluation may be of use in discriminating between different pathogenic factors in secondary amenorrhoea. This criterion may be applied to support the correct diagnosis of polycystic ovary syndrome (PCOS). Indeed, in line with the most recently proposed guidelines, patients affected by multifollicular ovaries could be classified as PCOS. The possibility of taking into account more than one US criterion or of carefully reanalysing the significance of increased stroma volume should be considered. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/16918963/Pituitary_ovarian_response_to_the_gonadotrophin_releasing_hormone_agonist_test_in_anovulatory_patients_with_polycystic_ovary_syndrome:_predictive_role_of_ovarian_stroma_ L2 - https://doi.org/10.1111/j.1365-2265.2006.02611.x DB - PRIME DP - Unbound Medicine ER -