Hormone levels following wedge resection in polycystic ovary syndrome

A study of serum estradiol, progesterone, 17alpha-hydroxy-progesterone, testosterone, dihydrotestosterone, dehydroepiandrosterone (DHA), delta4-androstenedione (delta4-A), FSH, and LH was carried out in one of three sisters having polycystic ovarian disease for a period of 18 days before wedge resection, at the time of surgery, and for 24 days following wedge resection. The mean levels of 17alpha-hydroxyprogesterone, testosterone, DHA, delta4-A, and LH were remarkably elevated prior to wedge resection. There was considerable day-to-day variation. Serum LH varied from 12.5 to 70.5 mIU/ml with a mean of 41.03 +/- 3.55 mIU/ml. Serum estradiol and progesterone levels were generally higher than those found in the early follicular phage. Wedge resection resulted in a fall in serum estradiol, progesterone, 17alpha-hydroxyprogesterone, DHA, and delta4-A. Ovarian secretion of the last four steroids was confirmed by a study of the ovarian vein blood obtained at the time of surgery. An estradiol peak occurred on the 14th post wedge resection day with smaller increases in 17alpha-hydroxyprogesterone, DHA and delta4-A. An increase in serum LH occurred on the 15th post wedge resection day with a peak on Day 16 accompanied by increases in FSH and progesterone. The postovulatory rise of progesterone was accompanied by reduction of serum LH levels to those generally found in the early part of the menstrual cycle. Various hypotheses for the ovulatory failure are discussed.