DOES GONADOTROPIN SUPPRESSION RESULT IN FOLLICULAR DEVELOPMENT IN PREMATURE OVARIAN FAILURE

It was hypothesized that premature ovarian failure is a self-perpetuat ing problem and that suppression of the endogenously raised gonadotrop in levels may allow synchronization of follicular growth, so that when the suppression is removed, follicular development may be stimulated by the rapid rise in follicle stimulating hormone (FSH) levels. Microg ynon(R) (ethinylestradiol, 30 mug and levonorgestrel, 150 mug) was adm inistered to eight women with premature ovarian failure for 12 weeks. Serum samples were collected weekly for radioimmunoassay of FSH, lutei nizing hormone (LH), estradiol, progesterone and inhibin. On stopping Microgynon, ovarian ultrasonography was carried out, in addition to bl ood sampling, to monitor any follicular growth. Both FSH and LH levels declined to the normal follicular-phase range after 5 weeks of Microg ynon treatment (mean +/- SD: FSH, 6.5 +/- 1.2 IU/l; LH, 8.9 +/- 1.6 IU /l). Both hormone levels rose rapidly after stopping treatment and wer e above the normal follicular-phase range by the 1st week. FSH reached pretreatment levels by 3 weeks, but LH did not reach the previously h igh levels until 7 weeks after stopping Microgynon administration. Est radiol and immunoreactive inhibin levels in serum were undetectable th roughout the study. No follicular growth was seen on ultrasound scanni ng. Therefore, gonadotropin suppression in premature ovarian failure d oes not result in a resumption of follicular activity.