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Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria.
Neuro Endocrinol Lett. 2011; 32(6):847-56.NE

Abstract

OBJECTIVE

As increased frequency of gonadotrophin-releasing hormone (GnRH) pulses is characteristic for polycystic ovary syndrome (PCOS), we assessed gonadotrophin response to GnRH in women with PCOS with normal and raised androgens and in regularly menstruating controls.

DESIGN, PATIENTS AND METHODS

The study involved 155 subjects: PCOS, n=121, age (mean±SD) 24.8±5.4 yrs, BMI 24.5±6.0 kg/m2, all with oligo-/amenorrhoea and PCO morphology, and 34 controls. Gonadotrophins were measured in early follicular phase after GnRH stimulation (0, 30 and 60 minutes).

RESULTS

Fifty four (41.9%) women with PCOS had androgens (testosterone, androstendione, dihydroepiandrosterone sulphate) within the reference range, and would fulfil the "Rotterdam", but not the Androgen Excess Society PCOS criteria. Baseline and stimulated LH concentrations were higher in PCOS (9.09±5.56 vs 4.83±1.71 IU/l, 35.48±31.4 vs 16.30±6.68 IU/l, 33.86±31.8 vs 13.45±5.2 IU/l, at 0, 30 and 60 min post GnRH, respectively, p<0.0001). An LH/FSH ratio in PCOS increased further after GnRH stimulation. ROC analysis revealed that LH30min/FSH30min >2.11 or LH60min/FSH60min >1.72 had 78.3% and 87.5% sensitivity and 81.7% and 81.3% specificity for diagnosis of PCOS. Both baseline and GnRH-stimulated LH and FSH concentrations were similar in women with PCOS and raised androgens and with androgens within the reference range (p=0.71 and p=0.20 for LH and FSH, respectively).

CONCLUSIONS

Regardless of their androgen status, women with PCO morphology and oligo-/amenorrhoea have higher baseline and GnRH-stimulated LH concentrations and higher GnRH-stimulated LH/FSH ratio than controls, suggestive of similar underlying mechanism accounting for menstrual irregularities. These observations support validity of PCOS diagnostic criteria based on the Rotterdam consensus.

Authors+Show Affiliations

Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22286802

Citation

Lewandowski, Krzysztof C., et al. "Women With Oligo-/amenorrhoea and Polycystic Ovaries Have Identical Responses to GnRH Stimulation Regardless of Their Androgen Status: Comparison of the Rotterdam and Androgen Excess Society Diagnostic Criteria." Neuro Endocrinology Letters, vol. 32, no. 6, 2011, pp. 847-56.
Lewandowski KC, Cajdler-Luba A, Bieńkiewicz M, et al. Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria. Neuro Endocrinol Lett. 2011;32(6):847-56.
Lewandowski, K. C., Cajdler-Luba, A., Bieńkiewicz, M., & Lewiński, A. (2011). Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria. Neuro Endocrinology Letters, 32(6), 847-56.
Lewandowski KC, et al. Women With Oligo-/amenorrhoea and Polycystic Ovaries Have Identical Responses to GnRH Stimulation Regardless of Their Androgen Status: Comparison of the Rotterdam and Androgen Excess Society Diagnostic Criteria. Neuro Endocrinol Lett. 2011;32(6):847-56. PubMed PMID: 22286802.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Women with oligo-/amenorrhoea and polycystic ovaries have identical responses to GnRH stimulation regardless of their androgen status: comparison of the Rotterdam and Androgen Excess Society diagnostic criteria. AU - Lewandowski,Krzysztof C, AU - Cajdler-Luba,Agata, AU - Bieńkiewicz,Małgorzata, AU - Lewiński,Andrzej, PY - 2011/10/30/received PY - 2011/11/28/accepted PY - 2012/1/31/entrez PY - 2012/1/31/pubmed PY - 2012/4/6/medline SP - 847 EP - 56 JF - Neuro endocrinology letters JO - Neuro Endocrinol. Lett. VL - 32 IS - 6 N2 - OBJECTIVE: As increased frequency of gonadotrophin-releasing hormone (GnRH) pulses is characteristic for polycystic ovary syndrome (PCOS), we assessed gonadotrophin response to GnRH in women with PCOS with normal and raised androgens and in regularly menstruating controls. DESIGN, PATIENTS AND METHODS: The study involved 155 subjects: PCOS, n=121, age (mean±SD) 24.8±5.4 yrs, BMI 24.5±6.0 kg/m2, all with oligo-/amenorrhoea and PCO morphology, and 34 controls. Gonadotrophins were measured in early follicular phase after GnRH stimulation (0, 30 and 60 minutes). RESULTS: Fifty four (41.9%) women with PCOS had androgens (testosterone, androstendione, dihydroepiandrosterone sulphate) within the reference range, and would fulfil the "Rotterdam", but not the Androgen Excess Society PCOS criteria. Baseline and stimulated LH concentrations were higher in PCOS (9.09±5.56 vs 4.83±1.71 IU/l, 35.48±31.4 vs 16.30±6.68 IU/l, 33.86±31.8 vs 13.45±5.2 IU/l, at 0, 30 and 60 min post GnRH, respectively, p<0.0001). An LH/FSH ratio in PCOS increased further after GnRH stimulation. ROC analysis revealed that LH30min/FSH30min >2.11 or LH60min/FSH60min >1.72 had 78.3% and 87.5% sensitivity and 81.7% and 81.3% specificity for diagnosis of PCOS. Both baseline and GnRH-stimulated LH and FSH concentrations were similar in women with PCOS and raised androgens and with androgens within the reference range (p=0.71 and p=0.20 for LH and FSH, respectively). CONCLUSIONS: Regardless of their androgen status, women with PCO morphology and oligo-/amenorrhoea have higher baseline and GnRH-stimulated LH concentrations and higher GnRH-stimulated LH/FSH ratio than controls, suggestive of similar underlying mechanism accounting for menstrual irregularities. These observations support validity of PCOS diagnostic criteria based on the Rotterdam consensus. SN - 0172-780X UR - https://www.unboundmedicine.com/medline/citation/22286802/Women_with_oligo_/amenorrhoea_and_polycystic_ovaries_have_identical_responses_to_GnRH_stimulation_regardless_of_their_androgen_status:_comparison_of_the_Rotterdam_and_Androgen_Excess_Society_diagnostic_criteria_ L2 - https://medlineplus.gov/polycysticovarysyndrome.html DB - PRIME DP - Unbound Medicine ER -