SERUM BIOACTIVE AND IMMUNOREACTIVE LUTEINIZING-HORMONE AND FOLLICLE-STIMULATING-HORMONE LEVELS IN WOMEN WITH CYCLE ABNORMALITIES, WITH OR WITHOUT POLYCYSTIC OVARIAN DISEASE

Serum steroid, gonadotropin, and alpha-subunit levels were assessed in 35 women with cycle abnormalities [11 with and 24 without polycystic ovarian disease (PCOD) according to strict clinical and biochemical criteria] and 8 regularly cycling women in the early (cycle day 3 or 4) and mid (cycle day 7 or 8) follicular phase. LH and FSH levels were estimated using two immunological techniques [RIA and immunoradiometric assay (IRMA)] and in vitro bioassays (BIO), using mouse Leydig cells and rat granulosa cells, respectively. In PCOD patients mean alpha-subunit, free androgen index [FAI; testosterone x 100/sex hormone-binding globulin (SHBG)], androstenedione, estrone, and estradiol (E2) were significantly elevated compared to levels in the early follicular phase of control cycles and non-PCOD patients. In addition, in PCOD patients mean IRMA-LH and RIA-LH levels were distinctly increased (2.8- to 3.6 fold, respectively; both comparisons, P < 0.001) compared to control values, but in the same order of magnitude (1.3- to 1.4-fold increments) as that in non-PCOD patients. However, the median BIO-LH level in PCOD patients was 5.9-fold higher than that in non-PCOD patients and 4.0-fold higher than the BIO-LH in the early follicular phase of control women. Consequently, the median BIO/IRMA-LH ratio was 4.8-fold higher in PCOD patients compared to non-PCOD patients. In women with cycle abnormalities, individual BIO/IRMA-LH ratios correlated with BIO-LH (r(s) = 0.48), FAI (r(s) = 0.39), free estrogens (E2/SHBG ratios; r(s) = 0 0.47), and dehydroepiandrosterone sulfate (r(s) = 0.60) concentrations. Mean IRMA-, RIA-, and BIO-FSH levels and BIO/IRMA-FSH ratios were not significantly different when various groups were compared. Although RIA- and IRMA-LH levels showed good correlation (r(s) = 0.88), RIA-LH levels were consistently higher, resulting in distinctly higher RIA-LH/FSH ratios (mean, 4.5) compared to IRMA-LH/FSH ratios (median, 1.8) in PCOD patients. The results presented in this study indicate: 1) there were no differences in mean serum levels of IRMA-FSH, RIA-FSH, and BIO-FSH when comparing PCOD, non-PCOD patients, and controls; 2) the LH/FSH ratio estimated by IRMA in PCOD patients is substantially lower than that measured by RIA (IRMA may not be useful to identify PCOD patients); 3) free alpha-subunit levels in PCOD patients are elevated compared to those in controls and non-PCOD patients; 4) BIO/IRMA-LH ratios in PCOD patients are significantly increased compared to those in non-PCOD patients; and 5) in women with cycle abnormalities, BIO/IRMA-LH ratios are correlated with FAI, E2/SHBG ratios, and dehydroepiandrosterone sulfate levels.