The use of a combined regimen of GnRH agonist plus a low-dose oral contraceptive improves the spontaneous pulsatile LH secretory characteristics in patients with polycycstic ovary disease after discontinuation of treatment

Purpose: The fertility rate in women with polycystic ovary disease (PCOD) is influenced by the type of treatment received. The present study evaluated the possible correlation between treatment and pulsatile release of gonadotropins. Methods: Spontaneous episodic secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and hormonal parameters were monitored before and after 1, 3, and 6 months after treatments suspension. Twenty-four PCOD patients were randomly divided into two groups of 12 subjects, Group A was treated with gonadotropin-releasing hormone (GnRH)-analogue pills ol al contraceptive (OC). Group B was treated only with OC. Both groups were treated for 6 months and followed up for 6 months. Results: hi all subjects the therapeutic regimens I-enticed the androgenic milieau and the gonadotropin plasma levels. Spontaneous pulsatile secretion of LH and FSH was significantly modified in both groups, but patients who received the combined regimen showed a significantly greater reduction of LH plasma levels and a significantly greater decrease of LH poise amplitude throughout the 6 months after treatment suspension. Ferriman-Gallway score and ovarian volumes Ir:er-e significantly,reduced in patients who received the combined treatment than in the OC-treated patients. Conclusions: These data support the evidence of a higher efficacy of the combination of GnRH-a + OC than OC alone bl restoring a normal and adequate spontaneous episodic gonadotropin discharge and in decreasing Ferriman-Gallway score and ovarian volumes in patients with PCOD.