Is diagnostic gonadotrophin stimulation useful?

Area of Science:

• Reproductive Endocrinology
• Gynecological Diagnostics

Background:

• The urinary oestrogen response to gonadotropin stimulation was previously used to diagnose menstrual irregularities like oligomenorrhoea/amenorrhoea.
• Polycystic ovarian disease (PCOD) was characterized by an excessive oestrogen response in this test.
• This study investigates the reliability of this diagnostic method.

Purpose of the Study:

• To evaluate the diagnostic accuracy of the standardized gonadotropin stimulation test for polycystic ovarian disease (PCOD).
• To assess the correlation between hormonal profiles (LH/FSH ratio) and laparoscopic findings in suspected PCOD.
• To determine the continued utility of the gonadotropin stimulation test in PCOD diagnosis.

Main Methods:

• Patients underwent diagnostic laparoscopy to confirm polycystic ovarian morphology.
• Urinary oestrogen excretion was measured following standardized gonadotropin stimulation.
• Plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were determined.

Main Results:

• Not all patients with laparoscopically confirmed polycystic ovaries exhibited an excessive urinary oestrogen response to gonadotropin stimulation.
• Conversely, some patients with laparoscopically normal ovaries showed an excessive response.
• A high LH/FSH ratio demonstrated a strong correlation with the laparoscopic diagnosis of polycystic ovaries.

Conclusions:

• The standardized gonadotropin stimulation test is not a reliable sole diagnostic tool for polycystic ovarian disease (PCOD).
• Diagnostic laparoscopy and plasma gonadotropin (LH/FSH ratio) measurements are more accurate for PCOD evaluation.
• Routine use of the gonadotropin stimulation test is discouraged where advanced diagnostic facilities are available.