FEMALE-PATIENTS WITH CYSTIC-FIBROSIS SUFFER FROM REPRODUCTIVE ENDOCRINOLOGIC DISORDERS DESPITE GOOD CLINICAL STATUS

Ten women with cystic fibrosis (CF) were evaluated with regard to horm onal profiles during a natural and a clomiphene citrate (CC) stimulate d cycle. Five of the women were found to be anovulatory during a natur al cycle. All women except one did respond with ovulation to CC stimul ation indicating adequate ovarian response. Neither did they show incr eased follicle-stimulating hormone (FSH) concentrations on day 10 afte r CC treatment confirming normal ovarian reserve. Clinically the anovu latory women differed from the ovulating in two aspects: more profound essential fatty acid deficiency (EFAD) and higher peak/basal insulin response during an oral glucose tolerance test. The anovulatory women had significantly lower luteal oestradiol and progesterone but higher total testosterone concentrations when compared to healthy controls an d the ovulatory CF women. The pathological insulin response and high t estosterone concentrations resemble those seen in women with polycysti c ovarian (PCO) syndrome. However, the CF patients in our study had no rmal ovaries, as deduced from ultrasound examination and normal lutein izing hormone (LH)/FSH ratio. It is suggested that EFAD as well as hyp ersecretion of insulin may be of importance for the observed ovarian d ysfunction. Further studies are needed to evaluate the relation betwee n ovulatory mechanisms and EFAD in CF women as well as studies to comp are anovulatory CF women with women with PCO syndrome.