Hormonal Contributions to the Recruitment of Follicular Development Following Ovarian Wedge Resection in Polycystic Ovary Syndrome

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The present study was performed in order to elucidate the mechanism of the recruitment of follicular growth and subsequent ovulation after ovarian wedge resection (WR). Seven patients with a diagnosis of PCO underwent WR. After taking 4 or 5 preoperative blood samples in the morning after their hospitalization, blood was obtained following the operation at 3-h intervals for the first 48h and at 1-3day intervals thereafter for 9-33days. These samples were analyzed for LH, FSH, estradiol, progesterone and androstenedione. Each ovarian tissue obtained by the operation was processed for histological examination. In 5 patients, the ovaries appeared to correspond with typical PCO. In the remaining<BR>2 patients, the histological features of the ovaries were consistent with a type of screlocystico-atrophic ovary according to Kusuda (1979). Some characteristic postoperative hormonal changes were observed in the patients with typical PCO who ovulated postoperatively. FSH started to increase from 3 to 30h after WR, and remained at higher levels for 2-7days. LH increased in a sporadic form shortly after WR and then declined in spite of sustained higher levels of FSH. Preoperative levels of androstenedione in the patients with typical PCO ranged between 2.0-3.4ng/ml, which exceeded serum levels in normal women. These high levels of androstenedione fell gradually following WR. There was an apparent decline of estradiol after WR in 2 out of 5 patients who ovulated postoperatively. A minor increase in progesterone occurred shortly after the operation, followed by a prompt decrease. In contrast, postoperative hormonal changes were minimal in the patients who did not ovulate postoperatively.<BR>The present study was performed in order to elucidate the mechanism of the recruitment of follicular growth and subsequent ovulation after ovarian wedge resection (WR). Seven patients with a diagnosis of PCO underwent WR. After taking 4 or 5 preoperative blood samples in the morning after their hospitalization, blood was obtained following the operation at 3-h intervals for the first 48h and at 1-3day intervals thereafter for 9-33days. These samples were analyzed for LH, FSH, estradiol, progesterone and androstenedione. Each ovarian tissue obtained by the operation was processed for histological examination. In 5 patients, the ovaries appeared to correspond with typical PCO. In the remaining 2 patients, the histological features of the ovaries were consistent with a type of screlocystico-atrophic ovary according to Kusuda (1979). Some characteristic postoperativehormonal changes were observed in the patients with typical PCO who ovulated postoperatively. FSH started to increase from 3 to 30h after WR, and remained at higher levels for 2-7days. LH increased in a sporadic form shortly after WR and then declined in spite of sustained higher levels of FSH. Preoperative levels of androstenedione in the patients with typical PCO ranged between 2.0-3.4ng/ml, which exceeded serum levels in normal women. These high levels of androstenedione fell gradually following WR. There was an apparent decline of estradiol after WR in 2 out of 5 patients who ovulated postoperatively. A minor increase in progesterone occurred shortly after the operation, followed by a prompt decrease. In contrast, postoperative hormonal changes were minimal in the patients who did not ovulate postoperatively.<BR>The postoperative hormonal changes including a decline in androstenedione, a temporary-minor increase in progesterone, a short-term sporadic increase in LH and a sustained increase in FSH may be involved in the mechanisms which account for the recruitment of follicular growth and subsequent ovulation after WR.
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Hormonal Contributions to the Recruitment of Follicular Development Following Ovarian Wedge Resection in Polycystic Ovary Syndrome

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