ORAL-CONTRACEPTIVE THERAPY FOR POLYCYSTIC OVARY DISEASE AFTER CHRONICGONADOTROPIN-RELEASING AGONIST ADMINISTRATION - PREDICTORS OF CONTINUED OVARIAN SUPPRESSION

OBJECTIVE: To study the beneficial effects of oral contraceptive (OC) therapy following gonadotropin-releasing hormone agonist (GnRH-a) admi nistration in women with polycystic ovary disease (PCOD). STUDY DESIGN : Twenty-three hyperandrogenic women (aged 15-39) were randomized into two groups; GnRH-a (depot every 28 days) for six months or combinatio n therapy (GnRH-a plus OC ''addback'') for six months. Following six m onths of treatment with either therapy, all patients received OC thera py for at least six months. The hormonal state wits evaluated at three -month intervals. RESULTS: Hormone levels of luteinizing hormone (LH), testosterone (T) and free T remained suppressed within the normal ran ge in II of 17 patients (65%) during the six months of OC-only therapy , while the other six patients showed ''escape'' from suppression, wit h the LH, T and free T concentrations rising to pre-GnRH-a treatment l evels. Use of Oc addback therapy did Mot potentiate the long-acting th erapeutic effect of GnRH-a pretreatment; three of six patients in the escape group were pretreated with combination therapy and three with G nRH-a only. CONCLUSION: In the majority of women with PCOD, OC therapy following GhRH-a administration was effective in maintaining ovarian androgen Suppression. Failure to maintain ovarian suppression in this patient population was associated with higher elevations of baseline f ree T concentrations.