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BONNEY RC, DALBY MC, NEWTON CJ, et al., 1989, 17-BETA-HYDROXYSTEROID OXIDOREDUCTASE ACTIVITY IN THE ENDOMETRIUM OF NORMAL WOMEN AND PATIENTS WITH PELVIC PAIN AND POLYCYSTIC OVARIES, JOURNAL OF STEROID BIOCHEMISTRY AND MOLECULAR BIOLOGY, Vol: 34, Pages: 535-539, ISSN: 0960-0760
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- Citations: 4
Franks S, 1989, Polycystic ovary syndrome., Trends Endocrinol Metab, Vol: 1, Pages: 60-63, ISSN: 1043-2760
This case illustrates the very common endocrine problem of polycystic ovary syndrome (PCOS). The diagnosis was not clear initially because of the absence of clinical evidence of androgen excess and of a normal random serum luteinizing hormone (LH) concentration. Futher investigations, however, confirmed polycystic ovaries on ultrasound and revealed a raised serum LH and elevated testosterone despite the lack of hirsutism. The patient's anovulatory infertility was treated by low dose human menopausal gonadotrophin (HMG), which resulted in ovulation of a single dominant follicle and pregnancy in the first cycle of treatment. This article discusses the endocrine features of hirsute and nonhirsute patients with PCOS, the choice of treatment for induction of ovulation, and comments on the possible mechanisms underlying PCOS.
Scanlon MJ, Whorwood CB, Franks S, et al., 1988, Serum androstanediol glucuronide concentrations in normal and hirsute women and patients with thyroid dysfunction., Clin Endocrinol (Oxf), Vol: 29, Pages: 529-538, ISSN: 0300-0664
There is currently much interest in measurements of 5 alpha-androstane-3 alpha, 17 beta-diol glucuronide (AdiolG) as a marker of peripheral androgen metabolism. We have therefore developed an assay to measure serum AdiolG levels and report that mean concentrations in hirsute (2.9 +/- 1.9 nmol/l, mean +/- SD, n = 15) and non-hirsute (1.9 +/- 0.6 nmol/l, n = 7) women with polycystic ovaries do not differ significantly from concentrations in normal women (2.2 +/- 0.8 nmol/l, n = 20). However, a correlation was found between serum AdiolG levels and Body Mass Index (r = 0.48, P less than 0.05) for women with polycystic ovaries, suggesting that weight may be an important factor in determining concentrations of this steroid conjugate. Serum AdiolG levels were significantly reduced in hypothyroid women (0.6 +/- 0.4 nmol/l, n = 5) and women receiving oral contraceptive therapy (0.6 +/- 0.4 nmol/l, n = 28) but increased in hyperthyroid women (4.0 +/- 0.6 nmol/l, n = 5). The results from this study do not support the hypothesis that serum AdiolG levels provide a marker of peripheral androgen metabolism in hirsute women and show that it is essential to exclude from such investigations any women with thyroid abnormalities or receiving oral contraceptive therapy.
SAGLE M, BISHOP K, RIDLEY N, et al., 1988, RECURRENT EARLY MISCARRIAGE AND POLYCYSTIC OVARIES, BMJ-BRITISH MEDICAL JOURNAL, Vol: 297, Pages: 1027-1028, ISSN: 1756-1833
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- Citations: 215
Bonney RC, Qizilbash ST, Franks S, 1988, Inhibition of phospholipase A2 isoenzymes in human endometrium by mefenamic acid and indomethacin: modulation by calcium ions., J Endocrinol, Vol: 119, Pages: 141-145, ISSN: 0022-0795
The inhibition of endometrial phospholipase A2 activity by the non-steroidal anti-inflammatory agents mefenamic acid and indomethacin was studied over the concentration range 1 mmol/1-0.1 mumol/l. Both phospholipase A2 type 1 (a calcium-dependent enzyme) and phospholipase A2 type 2 (a calcium-independent enzyme) were inhibited by mefenamic acid, but the magnitude of the inhibition was dependent on calcium concentration. Phospholipase A2 type 1 was inhibited 50% by 10 mumol mefenamic acid/l in the presence of 1.25-5 mmol calcium/l, but a concentration of 2.2 mmol mefenamic acid/l was required for 50% inhibition in the absence of calcium. On the other hand, phospholipase A2 type 2 was inhibited 50% by 22 mumol mefenamic acid/l in the absence of calcium and by 100 mumol mefenamic acid/l in the presence of calcium (2.5 mmol/l). Although indomethacin was a less effective inhibitor of phospholipase A2 activity, a similar relationship with calcium was demonstrated. However, indomethacin also had a stimulatory effect on phospholipase A2 type 1 activity in the absence of calcium. Our findings suggest that the two endometrial enzymes may be inhibited by different mechanisms and that the dependence of the enzyme on calcium for activation may be a contributing factor.
Polson DW, Reed MJ, Scanlon MJ, et al., 1988, Androstenedione concentrations following dexamethasone suppression: correlation with clomiphene responsiveness in women with polycystic ovary syndrome., Gynecol Endocrinol, Vol: 2, Pages: 257-264, ISSN: 0951-3590
It is difficult to predict clomiphene responsiveness in women with polycystic ovary syndrome (PCOS) but it has been suggested that women with evidence of excess adrenal androgen are less likely to respond to clomiphene. To investigate this further we performed a short Synacthen test following overnight dexamethasone suppression, using 11 beta-hydroxyandrostenedione (11-OHA) as a specific marker of adrenal androgen secretion in women with anovulatory infertility due to PCOS (n = 19) compared with a normal group (n = 7). Women with PCOS were subsequently divided into 2 groups according to whether or not they ovulated after clomiphene. On day 1 blood was taken at 9.00 hours for measurement of androstenedione (A), 11-OHA and cortisol, and 1 mg dexamethasone was given at 22.00 hours. On day 2 blood was taken at 9.00 hours and at 30 and 60 minutes after intravenous administration of 250 micrograms Synacthen. Before dexamethasone was given, concentrations of A but not of 11-OHA or cortisol were significantly higher in women with PCOS than in controls but there was no difference in A levels between clomiphene responders and non-responders. After 1 mg dexamethasone had been given, concentrations of A, 11-OHA and cortisol were suppressed in all 3 groups and there were no differences between the groups in the post-dexamethasone concentrations of 11-OHA or cortisol.(ABSTRACT TRUNCATED AT 250 WORDS)
RUTHERFORD AJ, SUBAKSHARPE RJ, DAWSON KJ, et al., 1988, IMPROVEMENT OF INVITRO FERTILIZATION AFTER TREATMENT WITH BUSERELIN, AN AGONIST OF LUTEINIZING-HORMONE RELEASING HORMONE, BRITISH MEDICAL JOURNAL, Vol: 296, Pages: 1765-1768, ISSN: 0959-8138
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- Citations: 150
Mason HD, Sagle M, Polson DW, et al., 1988, Reduced frequency of luteinizing hormone pulses in women with weight loss-related amenorrhoea and multifollicular ovaries., Clin Endocrinol (Oxf), Vol: 28, Pages: 611-618, ISSN: 0300-0664
We have studied pulsatile secretion of LH in 10 women with secondary amenorrhoea and multifollicular ovaries (MFO). This group of patients have a history of mild to moderate, or partially recovered weight loss. They have normal basal LH concentrations but evidence of oestrogen deficiency suggesting a hypothalamic abnormality of gonadotrophin regulation. The results of gonadotrophin pulse analysis were compared with those in normal women during the early follicular phase of the cycle. The mean LH concentration during the 8 h study (5.0 +/- 0.9 [SD] U/l) was not significantly different from that in normal women (5.7 +/- 2.5). There was no difference between the groups in mean LH pulse amplitude (2.1 +/- 0.5 in MFO; 2.2 +/- 1.3 in normal women). The frequency of LH pulses was, however, significantly lower in women with MFO (2.8 +/- 1.6 vs 4.8 +/- 1.5, P less than 0.05). Two women with MFO had LH pulses of normal frequency. One subsequently developed a normal pattern of ovarian follicles. The other showed a sleep-related rise in LH concentrations during a 24 h profile which was similar to the pattern of gonadotrophin secretion normally observed during late puberty. These results show that women with MFO have a hypothalamic disturbance of gonadotrophin regulation with slowing of LH pulses without a diminution of pulse amplitude.
Bonney RC, Franks S, 1988, The activity of calcium dependent and calcium independent phospholipase A2 in normal endometrium and in endometrium from women suffering from menorrhagia and polycystic ovary syndrome., Gynecol Endocrinol, Vol: 2, Pages: 131-138, ISSN: 0951-3590
The activity of 2 phospholipase A2 enzymes, PLA2(i) and PLA2(ii) was measured in endometrium in women with regular menstrual cycles without evidence of pathology and in those complaining of menstrual disturbances. There was a significant 4-fold increase in PLA2(i) activity in secretory phase endometrium (mean +/- SD: 32.7 +/- 9.5 pmol per mg protein/minute) compared to that of the proliferative and menstrual phases (9.5 +/- 4.9 and 6.1 +/- 2.6 pmol per mg protein/minute, respectively) but PLA2(ii) activity was variable and not related to the stage of the cycle (range: 4.0-97.0, 18.7-110.3 and 0.1-85.5 pmol per mg protein/minute for proliferative, secretory and menstrual phases, respectively). There was no significant difference between normal subjects and those with menorrhagia with respect to the mean activities of either isoenzyme at any stage of the cycle. Women with polycystic ovary syndrome (PCO) had markedly higher endometrial PLA2(ii) activity than normal subjects. The evidence of this study suggests that PLA2(ii) is not implicated in unexplained menorrhagia, but our preliminary findings indicate that the high level of PLA2(ii) activity found in the endometrium of women with PCO might be a marker of abnormal endometrial function.
Polson DW, Reed MJ, Franks S, et al., 1988, Serum 11 beta-hydroxyandrostenedione as an indicator of the source of excess androgen production in women with polycystic ovaries., J Clin Endocrinol Metab, Vol: 66, Pages: 946-950, ISSN: 0021-972X
Serum 11 beta-hydroxyandrostenedione levels (11-OHA) were measured in normal women and women with polycystic ovaries (PCO) to assess their value in localizing the source of excessive androgen production in women with PCO. Serum 11-OHA was undetectable (less than 1.5 nmol/L) in an adrenalectomized woman, a woman with 11-hydroxylase deficiency, and a woman receiving chronic dexamethasone therapy, confirming the specificity of the antiserum used in this study. Serum 11-OHA concentrations were similar in normal women [mean, 5.0 +/- 2.3 (+/- SD) nmol/L] and women with PCO (5.0 +/- 2.1 nmol/L); serum androstenedione concentrations were increased in women with PCO. Thus, the ratio of androstenedione to 11-OHA was significantly higher (P less than 0.001) in women with PCO (2.0 +/- 0.7) than in normal women (1.1 +/- 0.5). Serum 11-OHA levels after adrenal suppression or stimulation were similar in women with PCO who had an ovulatory response and those who failed to ovulate after clomiphene administration. Administration of dexamethasone (1 mg) and injection of ACTH (250 micrograms) were associated with marked suppression and subsequent stimulation of serum 11-OHA levels in both normal women and women with PCO, and the responses were similar in the two groups. Also, the hour to hour and diurnal variations in serum 11-OHA were similar to those of androstenedione and cortisol during a 24-h period, indicating the adrenal origin of 11-OHA. Our finding of similar serum 11-OHA levels in the presence of increased serum androstenedione levels in women with PCO supports the concept that the ovary is the major source of excess androgen production in women with PCO.
Bonney RC, Franks S, 1988, Hydrolysis of phosphatidylinositol by human endometrium: modulating effects of steroids on arachidonic acid and 1,2-diacylglycerol release., J Endocrinol, Vol: 117, Pages: 309-314, ISSN: 0022-0795
Phospholipase C and 1,2-diacylglycerol lipase activities were demonstrated in human endometrium using 1-stearoyl-2-[1-14C]arachidonyl phosphatidylinositol as substrate. Phosphatidylinositol is hydrolysed by phospholipase C to inositol phosphates and to 1,2-diacylglycerol which is then further metabolized by 1,2-diacylglycerol lipase to release free arachidonic acid. In the present study the radiolabelled products formed (1,2-diacylglycerol and arachidonic acid) were measured following chloroform/methanol extraction and thin-layer chromatography. Phospholipase C activity was calcium dependent and optimal at pH 5.0-5.5 and 7.5; 1,2-diacylglycerol lipase activity was also calcium dependent, with an optimum pH of 5.5. A significant increase in 1,2-diacylglycerol production was stimulated by steroid sulphates. Pregnenolone sulphate, oestrone sulphate, testosterone sulphate and dehydroepiandrosterone sulphate stimulated 4, 3.2-, 1.8- and 2.6-fold increases in release respectively. Oestradiol sulphate stimulated a 25% increase in diacylglycerol release which was not significantly different from the control value. Progesterone stimulated a fourfold increase but other free steroids had no effect. Arachidonic acid release was increased in the presence of oestradiol sulphate, oestrone and oestradiol but reduced by oestrone sulphate, dehydroepiandrosterone sulphate, progesterone, dehydroepiandrosterone and, to a lesser extent, by pregnenolone sulphate and testosterone sulphate. 5-Androstene-3 beta,17 beta-diol had no effect on the liberation of either product. This study demonstrates a potential route for the liberation of arachidonic acid from phosphatidylinositol in human endometrium. The opposing effects of steroids on phospholipase C and 1,2-diacylglycerol lipase activity could be important in regulating the release of arachidonic acid by this pathway.
FRANKS S, MASON HD, POLSON DW, et al., 1988, MECHANISM AND MANAGEMENT OF OVULATORY FAILURE IN WOMEN WITH POLYCYSTIC OVARY SYNDROME, HUMAN REPRODUCTION, Vol: 3, Pages: 531-534, ISSN: 0268-1161
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- Citations: 69
Polson DW, Adams J, Wadsworth J, et al., 1988, Polycystic ovaries--a common finding in normal women., Lancet, Vol: 1, Pages: 870-872, ISSN: 0140-6736
The prevalence of polycystic ovaries (PCO) in normal women of reproductive age was determined by pelvic ultrasound scanning of 257 volunteers who considered themselves to be normal and who had not sought treatment for menstrual disturbances, infertility, or hirsutism. All women had completed a menstrual history questionnaire. 99 women were on oral contraceptives at the time of the study. Of the 158 subjects who were not on oral contraceptives 18% had irregular cycles. 116 (73%) women had normal ovaries and 36 (23%) had PCO. 5 women had multifollicular ovaries and 1 had small, unstimulated ovaries. Only 1 woman with normal ovaries had an irregular menstrual cycle. Of the women with PCO, 76% had irregular cycles, and 6 of the 8 with regular cycles were hirsute. Women with and those without PCO differed in distribution of serum LH concentrations although the median values were similar. 25% of women with PCO had LH concentrations which exceeded the upper limit of the normal range. Thus PCO are common in normal women. Some of these women may have clinical and biochemical markers of PCO, which suggest that PCO in women who consider themselves to be normal is part of the same clinical spectrum as the classic Stein-Leventhal syndrome.
Sutherland IA, Chambers GR, Polson DW, et al., 1988, Pulsatile infusion of gonadotrophin releasing hormone (GnRH): investigative and therapeutic applications., J Biomed Eng, Vol: 10, Pages: 110-112, ISSN: 0141-5425
Normal gonadotrophin secretion, and therefore normal ovarian function, depend on delivery to the pituitary of the hypothalamic neuropeptide gonadotrophin releasing hormone (GnRH) in a pulsatile pattern. In the mid-follicular phase of the menstrual cycle, for example, discrete pulses of luteinizing hormone (LH) can be observed at approximately 90 min intervals. Many disorders of ovulation are caused by abnormalities of this natural pulsed signal. We have developed and used a small portable infusion pump to deliver GnRH to women with hypothalamic amenorrhoea; our studies, and those of other groups, have shown that successful ovulation and pregnancy result from such treatment. The results of treatment at St Mary's Hospital show that 16 women with hypogonadotrophic amenorrhoea received a total of 31 cycles of treatment with pulsatile GnRH; 25 (81%) of these cycles were ovulatory and 11 of the 14 women who were trying to conceive became pregnant. There was only one multiple pregnancy (twins).
Bonney RC, Franks S, 1987, Phospholipase C activity in human endometrium: its significance in endometrial pathology., Clin Endocrinol (Oxf), Vol: 27, Pages: 307-320, ISSN: 0300-0664
Phospholipase C activity was measured in human endometrium using an assay based on the release of total labelled water soluble products (inositol, inositol phosphates) from L-3-phosphatidyl-[2-3H] inositol. The enzyme was shown to be calcium dependent and to have an optimum pH of 5.5. There was no difference between proliferative phase and secretory phase endometrium with respect to phospholipase C activity either in women with normal menstrual blood loss (proliferative phase: 3.7 +/- 0.7 (mean +/- SD), secretory phase: 4.5 +/- 2.0 nmol/mg protein/min) or in those complaining of severe menorrhagia (proliferative phase: 5.8 +/- 2.8, secretory phase: 7.0 +/- 2.8 nmol/mg protein/min). However, women complaining of severe menorrhagia had significantly higher endometrial phospholipase C activity than those in the normal group (P less than 0.01 and P less than 0.02 for proliferative and secretory phases respectively). Endometrial phospholipase C activity was also elevated in the presence of other gynaecological disorders, e.g. dysmenorrhoea, adenocarcinoma of the cervix and endometrial hyperplasia. The results indicate that phospholipase C activity in human endometrium is not related to the stage of the menstrual cycle but that in the presence of menorrhagia and other gynaecological disorders, activity is increased. Phospholipase C could be implicated in the generation of arachidonic acid for prostaglandin synthesis which may in turn be associated with these abnormalities.
Polson DW, Sagle M, Mason HD, et al., 1987, Recovery of luteal function after interruption of gonadotrophin secretion in the mid-luteal phase of the menstrual cycle., Clin Endocrinol (Oxf), Vol: 26, Pages: 597-600, ISSN: 0300-0664
Ovulation was induced by a pulsatile infusion of GnRH in a patient with hypogonadotrophic amenorrhoea. In order to investigate the effect of short-term withdrawal of gonadotrophin support in the luteal phase, the pulsatile infusion was stopped 3 d after ovulation and restarted 48 h later. After stopping the pump gonadotrophin and progesterone concentrations fell rapidly to very low levels, but when the infusion was restarted progesterone concentrations returned to normal mid-luteal values. Menstruation occurred 14 d after the LH surge. We conclude that normal progesterone secretion by the corpus luteum can be restored after temporary withdrawal of gonadotrophin support.
Polson DW, Franks S, Reed MJ, et al., 1987, The distribution of oestradiol in plasma in relation to uterine cross-sectional area in women with polycystic or multifollicular ovaries., Clin Endocrinol (Oxf), Vol: 26, Pages: 581-588, ISSN: 0300-0664
The uterine cross-sectional area (UXA) of women with polycystic (PCO) or multifollicular ovaries (MFO) is significantly larger and smaller, respectively, than those of normal women during the early-mid-follicular phase of the menstrual cycle. In the present study the distribution of oestradiol in plasma from normal women and women with PCO or MFO was measured to determine if differences in the available fractions of oestradiol could account for the differences in UXA of women with PCO or MFO. No differences in plasma levels of oestradiol were detected and the concentrations of oestradiol present in a free state or bound to albumin were similar in normal women and women with PCO or MFO. The concentration of oestrone was significantly higher in plasma from women with PCO (516 +/- 120 pmol/l, mean +/- SD) than in plasma from women with MFO (389 +/- 91 pmol/l) or normal women (376 +/- 89 pmol/l). Differences in UXA for women with PCO or MFO as compared with normal women cannot therefore be attributed to differences in available oestradiol concentrations. It is possible that abnormalities in oestrogen metabolism within uterine or other tissues may account for the UXA of women with PCO or MFO. Increased plasma oestrone levels in women with PCO may provide more substrate for conversion to oestradiol within the uterus whilst the smaller UXA of women with MFO may reflect both lack of normal cyclical increases of oestradiol and formation of biologically inactive oestradiol metabolites.
FRANKS S, NEAGLE G, LEAKE R, et al., 1987, EPIDERMAL GROWTH-FACTOR (EGF) CONCENTRATIONS IN FOLLICULAR-FLUID FROM NORMAL OR POLYCYSTIC OVARIES (PCO), JOURNAL OF ENDOCRINOLOGY, Vol: 112, Pages: 120-120, ISSN: 0022-0795
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- Citations: 12
Polson DW, Mason HD, Saldahna MB, et al., 1987, Ovulation of a single dominant follicle during treatment with low-dose pulsatile follicle stimulating hormone in women with polycystic ovary syndrome., Clin Endocrinol (Oxf), Vol: 26, Pages: 205-212, ISSN: 0300-0664
Ten women with clomiphene-resistant chronic anovulation associated with polycystic ovary syndrome were treated with purified urinary FSH (urofollitrophin). The gonadotrophin was given s.c. by pulsatile infusion pump starting at a low dose (1 ampoule or 75 U/d) and increasing by 37.5 U/d at weekly stages in an attempt to induce ovulation of a single follicle. Seventy percent of the 33 cycles were ovulatory and in 18 of these (78%) a single dominant follicle developed and ovulated. Each of the 10 women ovulated when the optimum dose was reached and five of these women became pregnant. The maximum dose of FSH in uni-ovulatory cycles was 150 U/d or less. Endogenous LH concentrations which were raised at the onset of treatment were suppressed in the late follicular phase. The rate of follicular growth and gonadal steroid concentrations were consistent with those observed in spontaneous ovulatory cycles. This study demonstrates that by using low-dose gonadotrophin therapy it is possible to find the 'threshold' dose of FSH to promote maturation of a single dominant follicle. The high rate of ovulation and pregnancy suggest that this approach is of practical importance in treatment of infertile patients with polycystic ovaries.
Polson DW, Mason HD, Franks S, 1987, Bromocriptine treatment of women with clomiphene-resistant polycystic ovary syndrome., Clin Endocrinol (Oxf), Vol: 26, Pages: 197-203, ISSN: 0300-0664
Twenty-three patients with polycystic ovary syndrome and anovulatory infertility have been treated with bromocriptine. All had previously failed to respond to clomiphene. Twenty had normal serum prolactin concentrations and, of these, four (20%) developed regular ovulatory cycles. All three women with moderate hyperprolactinaemia ovulated regularly on bromocriptine so that, overall, seven of 23(30%) responded, which was a significantly higher proportion than that observed during a control period of no treatment. A further eight women ovulated at least once during the study period but these occasional ovulations were no more common during bromocriptine than with either clomiphene or no treatment. No suppression of LH was noted except during the luteal phase of ovulatory cycles and there was no change in the pattern of pulsatile release of LH. Testosterone and androstenedione concentrations remained elevated and unchanged. We conclude that bromocriptine may be expected to induce ovulation in hyperprolactinaemic women with polycystic ovary syndrome but that there is no clear indication for its use in clomiphene-resistant patients with normal serum prolactin concentrations.
Bonney RC, Qizilbash ST, Franks S, 1987, Endometrial phospholipase A2 enzymes and their regulation by steroid hormones., J Steroid Biochem, Vol: 27, Pages: 1057-1064, ISSN: 0022-4731
The presence of two phospholipase A2 (PLA2) enzymes, designated PLA2(i) and PLA2(ii), has been demonstrated in human endometrium. These enzymes differ with respect to pH and calcium requirements, location within the tissue and regulation by steroid hormones. Phospholipase A2(i) is calcium dependent, optimally active at pH 7.5-9.0 and present mainly in the glandular component of the endometrium. Changes in activity occur during the menstrual cycle which are indicative of regulation by ovarian steroids. Conversely, PLA2(ii) is calcium independent, optimally active at pH 7.0 and located predominantly in the stromal layer. Wide variation in PLA2(ii) activity was found between individual subjects and there was no relationship with the stage of the menstrual cycle. Activity was, however, much higher in pathological endometrium and in endometrium from subjects with severe dysmenorrhoea. Triton X-100 activated PLA2(i) but not PLA2(ii). In cultured explants of endometrium, both enzymes were inhibited by progesterone whereas oestradiol and dexamethasone had no effect. However, progesterone priming followed by treatment with oestradiol caused a 2-fold stimulation of PLA2(i) but not PLA2(ii). Phospholipase A2 is favoured as the rate-limiting step in the generation of arachidonic acid for prostaglandin synthesis. However, our studies so far do not support a direct relationship between PLA2 and endometrial concentrations of prostaglandins, which implies that other important regulatory steps are involved. Other enzymes which are potentially capable of mobilizing arachidonic acid should also be investigated.
Franks S, Sagle M, Mason HD, et al., 1987, Use of LHRH agonists in the treatment of anovulation in women with polycystic ovary syndrome., Horm Res, Vol: 28, Pages: 164-168, ISSN: 0301-0163
The long-acting agonist analogue of LHRH, Buserelin (Hoechst) has been used to suppress endogenous gonadotrophins prior to induction of ovulation with low dose human menopausal gonadotrophin (HMG) in women with clomiphene-resistant polycystic ovary syndrome (PCOS). The results have been compared with those in a similar group of patients treated with HMG alone. Buserelin (900-1,500 micrograms/day) was given intranasally to 11 women who thereafter received a total of 33 cycles of treatment with low-dose HMG. The control group comprised 16 women who received 40 cycles of HMG without Buserelin pretreatment. The ovulation rate was similar in the two groups: Buserelin + HMG 70%, HMG alone 68% and both groups showed a high rate of single follicle ovulation (52 and 63%, respectively). The threshold dose of gonadotrophin required to induce a single follicle was similar in the two groups. Premature elevation of LH in the late follicular phase was common in women who received HMG alone, but did not occur in any cycle in the patients receiving Buserelin pretreatment. In summary, these data show that pretreatment with an LHRH analogue prevents a premature LH surge but it remains to be determined whether this will have a significant bearing on the rate of successful pregnancy in women with PCOS.
POLSON DW, ADAMS J, STEER PJ, et al., 1986, UNILATERAL POLYCYSTIC OVARY - CASE-REPORT, BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 93, Pages: 1100-1103, ISSN: 0306-5456
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- Citations: 14
Afnan AM, Hillier SG, Margara RA, et al., 1984, Pulsatile gonadotropin administration in in-vitro fertilisation., Lancet, Vol: 1, ISSN: 0140-6736
AFNAN AMM, HILLIER SG, MARGARA RA, et al., 1984, PULSATILE GONADOTROPIN ADMINISTRATION IN INVITRO FERTILIZATION, LANCET, Vol: 1, Pages: 1239-1239, ISSN: 0140-6736
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- Citations: 9
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