NDLI: Ovarian luteinizing hormone priming preceding follicle-stimulating hormone stimulation: clinical and endocrine effects in women with long-term hypogonadotropic hypogonadism.

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Ovarian luteinizing hormone priming preceding follicle-stimulating hormone stimulation: clinical and endocrine effects in women with long-term hypogonadotropic hypogonadism.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Carmona, Francisco Tena-Sempere, Manuel Fábregues, Francisco Balasch, Juan Casamitjana, Roser
Description	Country affiliation: Spain Author Affiliation: Balasch J ( Institute Clinic of Gynecology, Obstetrics, and Neonatology, Hospital Clínic-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine-University of Barcelona, 08036 Barcelona, Spain. jbalasch@ub.edu)
Abstract	CONTEXT: Patients with hypogonadotropic hypogonadism (HH), who may be totally LH deficient, remain the primary clinical model for investigating the physiology of gonadotropin actions on ovarian steroidogenesis and follicular development. OBJECTIVES: Our objective was to investigate the effects of LH pretreatment on subsequent ovarian stimulation with FSH in longstanding HH women. DESIGN AND SETTING: A prospective, self-controlled study was conducted at a university tertiary-care center. PATIENTS AND INTERVENTIONS: Eight HH women (six idiopathic, two surgical) underwent ovarian stimulation with recombinant human (rh)FSH preceded or not by rhLH administration in two separate cycles. In one additional patient with idiopathic HH, pretreatment was conducted with recombinant human chorionic gonadotropin (rhCG) instead of rhLH. MAIN OUTCOME MEASURES: Follicular development and serum hormone concentrations throughout LH-FSH and FSH treatment cycles were assessed. RESULTS: Pretreatment with rhLH significantly decreased the mean threshold (daily effective) FSH dose and tended to lower the total amount of FSH required to induce follicular maturation in association with appropriate serum estradiol levels and endometrial thickness. Unexpectedly, in HH women retaining functional pituitary tissue, pretreatment with rhLH evoked a consistent elevation of serum LH levels during FSH administration, an effect that was also induced, even at higher magnitude, by pretreatment with rhCG. CONCLUSIONS: In addition to changes in FSH requirements for follicular maturation, pretreatment with rhLH/rhCG evoked unambiguous elevations in serum levels of endogenous LH during FSH treatment in HH patients with preserved pituitary function. This is suggestive of a novel regulatory loop of LH secretion involving gonadotropin-stimulated ovarian factors whose nature and physiological relevance are yet to be disclosed, ovarian-derived kisspeptins being appealing candidates.
ISSN	0021972X
e-ISSN	19457197
Journal	The Journal of Clinical Endocrinology & Metabolism
Issue Number	7
Volume Number	94
Language	English
Publisher	Oxford University Press
Publisher Date	2009-07-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Follicle Stimulating Hormone Administration & Dosage Hypogonadism Drug Therapy Luteinizing Hormone Ovary Drug Effects Ovulation Induction Androstenedione Blood Cell Size Drug Administration Schedule Estradiol Ovarian Follicle Pathology Recombinant Proteins Time Factors Ultrasonography Controlled Clinical Trial Research Support, Non-u.s. Gov't Discipline Endocrinology Discipline Metabolism
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Endocrinology, Diabetes and Metabolism Clinical Biochemistry Biochemistry Endocrinology

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