Diagnostic problems on nosographic classification of polycystic disease of the ovary

Nineteen patients with polycystic disease of the ovary have been studied. From the humoral point of view the group was found to consist of two populations distinguishable from one another by their basal LH levels. In type I cases LH was definitely increased (M = 53.46 +/- 12.79 mIU/ml) whereas FSH (M = 8.10 +/- 0.74 mIU/ml), prolactin (M = 10.48 +/- 2.12 ng/ml), 17beta-estradiol (M = 124.76 +/- 11.21 pg/ml), progesterone (M = 0.321 +/- 0.078 ng/ml) were all within the normal range for the follicular phase of the menstrual cycle. Testosterone levels were raised (M = 121.15 +/- 24.55 ng/100 ml) but not to an extent significantly different from that of patients with type II disease (M = 119,5 +/- 33.53 ng/100 ml). All the other hormonal parameters were within the normal range also in type II disease; for LH the difference between the means of the two groups was statistically significant (p less than 0.01). Urinary 17-ketosteroids were not significantly different in the two groups of patients and the values found always fell within the normal range for our laboratory. LH-RH stimulation (50 microgram i.v.) elicited an exaggerated response in type I and a normal one in type II. The FSH response was always deficient and delayed in both groups. Since there was no correlation of the humoral data to the macroscopic aspect of the ovary as visualized by celioscopy, the practical importanze of endocrine exploration of these cases is stressed, especially as regards LH levels and androgen secretion, at least for the identification of cases in which polycystic disease of the ovary is suspected.