Human Reproduction, Vol. 16, No. 8, 1603-1610,
August 2001
© 2001 European Society of Human Reproduction and Embryology
Resumption of ovarian function during lactational amenorrhoea in breastfeeding women with polycystic ovarian syndrome: endocrine aspects
1 Division of Endocrinology, Department of Internal Medicine, School of Medicine, University of Chile, 2 Institute of Maternal and Child Research, University of Chile, 3 Laboratory of Sleep and Functional Neurobiology, INTA, University of Chile, Santiago, 4 Laboratory of Animal Physiology and Endocrinology, School of Veterinary Medicine, University of Concepción, Chillán, Chile and 5 Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, University of Erlangen, Erlangen, Germany
BACKGROUND: The aim of this study was to evaluate the changes in gonadotrophin concentrations and the dynamics of the episodic fluctuations of circulating LH during night-time, in fully breastfeeding normal women and in those with polycystic ovarian syndrome (PCOS) during lactational amenorrhoea and after weaning, in order to provide insights into the onset of this syndrome. Additionally, ovarian activity was evaluated by ultrasound examination and steroid concentrations. METHODS: Twelve lactating PCOS (LPCOS) women and six normal lactating (NL) women of similar age were selected. On the 4th and 8th week postpartum (PP) and eight weeks after weaning, blood samples were collected every 10 min (10.00–20.00h). Gonadotrophin concentrations were determined in all samples. Steroid hormones were measured in one fasting sample and ovarian morphology was assessed by ultrasound. RESULTS: On the 8th week PP, LH pulse frequency was higher and FSH concentrations were lower in LPCOS women compared with NL women, and steroid hormone concentrations remained low, except for androstenedione which was higher in LPCOS patients. After weaning, similar differences were observed between both groups. PCOS patients also showed enlarged ovaries with a PCOS pattern in the three study periods. CONCLUSIONS: The enlarged ovaries associated with higher androstenedione concentrations suggest that PCOS is a primary ovarian defect, making it difficult to establish if the abnormal LH pattern observed in these women is primary or secondary to the ovarian dysfunction.
Key words: LH/lactation/PCOS
6 To whom correspondence should be addressed at: Las Palmeras 299, Interior Quinta Normal Casilla 33052, Correo 33, Santiago, Chile. E-mail: tsir{at}entelchile.net
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