Human Reproduction, Vol 13, 22-26, Copyright © 1998 by Oxford University Press
T Kaltsas, N Pontikides, GE Krassas, K Seferiadis, D Lolis and IE Messinis
The suppression of the pituitary-gonadal axis by the administration of
gonadotrophin-releasing hormone agonists (GnRH-a) is used occasionally as
an adjunct therapy with gonadotrophins for ovulation induction in women
with polycystic ovarian syndrome (PCOS). A number of recent clinical
studies have suggested that women with polycystic ovaries (PCO) may have
disturbances of normal growth hormone (GH) kinetics and alterations in the
GH/insulin-like growth factor (IGF)-I system. The purpose of this study was
to determine the effect of GnRH-a administration on GH-releasing hormone
(GHRH)-stimulated GH release in women with PCOS. Eight women with PCO and
six control women were studied before and after 2 months of treatment with
the long acting GnRH-a triptoreline (3.75 mg monthly injections). GHRH was
given as a single i.v. injection and blood samples for GH measurements were
obtained at -15, 0, 30, 60, 90 and 120 min. The GH responses were expressed
as the area under the curve (AUC) or the differences from the basal value
(delta(max)). The GH response to GHRH (mean +/- SEM) was lower in women
with PCO (AUC 114.9 +/- 43.1 versus 206.2 +/- 28.7 ng/ml/120 min, P <
0.05 and delta(max) 31.6 +/- 8.2 versus 49.4 +/- 5.8 ng/ml, P < 0.05).
After treatment with the GnRH-a, the GH response to GHRH was significantly
smaller than before treatment in both groups (PCO AUC 34.6 +/- 9.0
ng/ml/120 min and delta(max) 12.4 +/- 3.1 ng/ml; controls AUC 148.8 +/-
28.4 ng/ml/120 min and delta(max) 31.2 +/- 6.1 ng/ml), but the PCO group
had a significantly smaller response. These data demonstrate that women
with PCO have a reduced GH response to GHRH compared with normal controls
and that GnRH-a administration causes a further GH reduction in both
groups. Women with PCO have a greater suppression of GH response to GHRH
during treatment with GnRH-a. This suggests that a different level of
sensitivity in the somatotrophic axis exists in PCOS.
ARTICLES
Effect of gonadotrophin-releasing hormone agonist treatment on growth hormone secretion in women with polycystic ovarian syndrome
Endocrine Clinic, PANAGIA Hospital, Thessaloniki, Greece.
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