Hormonal effects of wedge resection of polycystic ovaries

Plasma FSH, LH, estradiol, testosterone, and progesterone were measured serially before, during, and after bilateral ovarian wedge resection in 2 patients with polycystic ovaries. Preoperatively both were anovulatory with persistently elevated plasma LH values and 1 patient had high testosterone concentrations. Plasma FSH, estradiol, and progesterone were within the normal midfollicular phase range. The LH:FSH ratio was increased and no cyclic gonadotropic activity occurred. During surgery progesterone levels rose while estradiol concentrations fell. In both patients, the initial reduction in estradiol secretion was observed after unilateral wedge resection but testosterone concentrations only declined 6-24 hours postoperatively. During the first postoperative week the LH:FSH ratio fell significantly and cyclic gonadotropic activity, in the form of sporadic LH and FSH spurts, was noted. In the second week after surgery, and estradiol surge occurred followed by preovulatory LH and FSH peaks, ovulation, and a normal luteal phase. Spontaneous menstruation occurred by the end of the first postoperative month and both patients conceived within 4 months of surgery.