Plasma hormones in human gonadotropin induced ovulation

Area of Science:

• Reproductive Endocrinology
• Hormone Analysis
• Infertility Treatment

Background:

• Assessing hormonal profiles during ovulation induction is crucial for understanding treatment efficacy and side effects.
• Human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) are commonly used to stimulate ovulation in infertile patients.
• Understanding the dynamic changes in reproductive hormones is key to optimizing assisted reproductive technologies.

Observation:

• Daily plasma samples were analyzed for follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrone (E1), estradiol-17beta(E2), progesterone (P), androstenedione (A), and testosterone (T) during hMG-hCG induced ovulation cycles.
• During hMG administration, plasma FSH levels increased (20-30 mIU/mL) while LH remained low, resulting in a plasma FSH/LH ratio consistently above 1.
• Plasma androgen levels (A and T) remained within the normal range throughout the hMG-hCG therapy cycles.

Findings:

• The elevated FSH/LH ratio during hMG-hCG therapy, contrasting with normal ovulatory cycles, may contribute to multiple follicular development and ovulation.
• Higher than normal plasma progesterone levels observed in hMG-hCG cycles are likely associated with multiple ovulations.
• No significant hormonal differences were found between pregnant and non-pregnant outcomes, nor between single and multiple ovulations, except for higher progesterone in multiple ovulations.

Implications:

• The pharmacologically induced high FSH/LH ratio in hMG-hCG therapy could be a key factor in the frequent occurrence of multiple ovulations.
• The normal androgen levels during hMG-hCG treatment differ from clomiphene citrate cycles, suggesting distinct mechanisms of action and potential side effect profiles.
• Consistent ovarian response and hormonal patterns observed across multiple cycles in an individual highlight the predictability of hMG-hCG treatment for some patients.