Sonographic parameters and hormonal status in lean and obese women with polycystic ovary syndrome.

A total of 34 patients with the diagnosis of polycystic ovary syndrome (PCOS) were recruited for this study. Weight distribution in lean PCOS women (n = 17) was 93.5% to 110.5% of normal weight for height and age. In obese women (n = 17) this distribution was 119.5 to 146.5%. Serum testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), delta 4-androstendione (delta 4-A), sex hormone binding globulin, (SHBG), 17-hydroxyprogesterone (17-OH PRG), 17b oestradiol (17b-E2), cortisol (CORT), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and insulin (INS) were measured. Serum SHBG levels were lower in obese PCOS women (72.9 +/- 16.2 nmol/l) than in lean PCOS women (99.6 +/- 10.5) (p < 0.001). Fasting insulin levels were higher in obese PCOS women (30.4 +/- 4.5 mUI/ml) than in lean PCOS women (14.2 +/- 7.6 mUI/ml) (p < 0.001). Mean ovarian volume did not differ significantly between lean and obese PCOS women (12.5 +/- 3.7 ml vs 16.1 +/- 5.3, p > 0.5). Endometrial thickness was roughly similar between the two groups. Endometrial surface area in lean PCOS women (7.6 +/- 2.2 cm2) was lower than in obese PCOS women (10.1 +/- 1.9 cm2) and the difference was significant (p < 0.01).

Hormonal reproductive status of women at menopausal transition compared to that observed in a group of midreproductive-aged women.

OBJECTIVE: To compare the serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) in perimenopausal women to the levels of the same reproductive hormones in younger women. METHODS: This was a case control study which compared the hormonal status (circulating levels of FSH, LH, PRL, T, E2, DHEA-S) between women at menopausal transition and younger mid-reproductive-aged controls. The t-test for independent samples was used. RESULTS: FSH, LH and E2 were higher, and T and DHEA-S were lower in perimenopausal women. CONCLUSION: The reproductive hormonal patterns in perimenopausal women favor a relatively hypergonadotropic hyper-estrogenic milieu.

The conservative surgical treatment of endometriosis: evaluation of pregnancy success with respect to the extent of disease as categorized using contemporary classification systems.

A homogeneous group of 214 infertile women with endometriosis treated at the Johns Hopkins Hospital from 1960 to 1979 received conservative surgery as the sole therapeutic modality. Among this group, 115 patients (54%) conceived following surgery; of these conceptions, 109 resulted in a living child. Among 49 patients with secondary infertility, the spontaneous abortion rate was reduced from 49% to 20% after conservative surgery (P less than or equal to 0.01). Three contemporary classification systems were utilized to categorize patients according to the sites and amount of endometriosis at the time of conservative surgery. Those systems suggested by Buttram (Fertil Steril 30:240, 1978) and by Kistner and coauthors (Fertil Steril 28:108, 1977) revealed differences among fecundability rates among the different categories (P less than or equal to 0.01); however, the system suggested by The American Fertility Society (AFS) (Fertil Steril 32:633, 1979) revealed significant differences only if categories were combined (mild plus moderate versus severe plus extensive, P less than or equal to 0.05). Nevertheless, the AFS system revealed that pregnancy success was significantly reduced if an ovarian endometrioma was greater than 3 cm or had ruptured (P less than or equal to 0.01).