Plasma Hormones in Human Gonadotropin Induced Ovulation

Abstract

Plasma follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrone (E,), estradiol-17β (E₂), progesterone (P), androstenedione (A), and testosterone (T) were analyzed in daily plasma samples of seven cycles of human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG) induced ovulation. Plasma FSH rose gradually and remained at a higher level (20 to 30 mlU/ml) during hMG injection while LH stayed at a low tonic level. The FSH/LH ratio of plasma gonadotropins was consistently higher than 1 in spite of injecting an hMG preparation with FSH/LH ratio of 1. A pharmacologically induced high FSH/LH ratio in the late follicular phase is contradictory to the low ratio seen in the normal ovulatory cycle. This may be one of the causes of multiple follicular maturation and ovulation frequently encountered in the hMG-hCG induced ovulation. Higher than normal levels of plasma progesterone commonly seen in the hMG-hCG induced cycle is attributed to the multiple ovulation. Plasma androgen levels, both A and T, in these therapy cycles stayed consistently within normal range. This is a strong contrast to the clomiphene induced cycle in which A and T were frequently elevated in parallel with elevated LH. No significant differences in plasma hormones were observed between the pregnant and nonpregnant patients following hMG-hCG induced ovulation. A consistent and similar ovarian response to hMG-hCG was noted in 1 individual who had 3 consecutive therapy cycles studied. The plasma hormone levels in the multiple ovulation did not show a significant difference from those in the single ovulation with the exception of a higher plasma P level in the former.