OVARIAN RESPONSE TO PURIFIED FSH IN INFERTILE WOMEN WITH LONG-STANDING HYPOGONADOTROPIC HYPOGONADISM

It has previously been proposed that all anovulatory women requiring e xogenous gonadotrophin therapy could be treated by purified FSH alone in the follicular phase. We have studied the ovarian response to purif ied FSH in 5 amenorrhoeic women with low endogenous LH production as a result of longstanding hypothalamic amenorrhoea. Follicles developed in all of the women but the rise in oestradiol was very slow. As a con sequence of the HCG injection being delayed to allow the follicles to become functionally mature, too many follicles attained a preovulatory size. After the treatment was changed to more conventional preparatio ns containing both FSH and LH, the women had improved ovarian response s and 3 of them conceived. It is clear that FSH alone will promote fol licular growth but that LH is needed to stimulate follicular function. We conclude that LH does play an important role in follicular maturat ion and that it is a critical component of exogenous gonadotrophin the rapy for women with prolonged hypogonadotrophic hypogonadism.