Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones**Supported by grants from the Faculty of Medicine, University of Göteborg, The Göteborg Medical Society and the Research and Development Foundation, Bohuslandstinget, Göteborg, Sweden.

Oestradiol and progesterone profiles from naturally occurring conception and exposed non-conception cycles were compared to assess the impact of natural variation in concentrations of ovarian steroid hormones on female fecundity. In a prospective, longitudinal study, 24 women collected saliva samples twice daily and recorded intercourse for up to 1 year or until a pregnancy was clinically confirmed. Oestradiol and progesterone concentrations were measured by a salivary radioimmunoassay. Average mid-follicular oestradiol concentrations were significantly higher in conception than in non-conception cycles (12.6 +/- 1.7 versus 8.5 +/- 0.6 pmol/l, P < 0.01). A separate analysis, including only cycles from those women who contributed both conception and non-conception cycles, demonstrated an even more pronounced difference in mid-follicular oestradiol concentrations, not just for conception and non-conception cycles as groups (14.5 +/- 2.3 versus 6.5 +/- 0.7 pmol/l, P < 0.001), but also between the conception and average non-conception concentrations of individual women. Among these women, relative mid-follicular oestradiol concentration was highly correlated with the probability of successful conception. In addition, relative body weight was significantly positively correlated with mid-follicular oestradiol concentration. These findings indicate that variation in follicular development, reflected in variation in follicular oestradiol concentrations, is an important indicator of fecundity.

EndocrinologyComparison of salivary steroid profiles in naturally occurring conception and non-conception cycles

A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion

OBJECTIVE--To examine the impact of amenorrhoea on bone mineral density in women of reproductive age. DESIGN--Cross sectional study of 200 amenorrhoeic women compared with normally menstruating controls. SETTING--Teaching hospital outpatient clinic specialising in reproductive medicine. SUBJECTS--200 Women aged 16-40 with a past or current history of amenorrhoea from various causes and of a median duration of three years, and a control group of 57 age matched normal volunteers with no history of menstrual disorder. MAIN OUTCOME MEASURE--Bone mineral density in the lumbar spine (L1-L4) as measured by dual energy x ray absorptiometry. RESULTS--The amenorrhoeic group showed a mean reduction in bone mineral density of 15% (95% confidence interval 12% to 18%) as compared with controls (mean bone mineral density 0.89 (SD 0.12) g/cm2 v 1.05 (0.09) g/cm2 in controls). Bone loss was related to the duration of amenorrhoea and the severity of oestrogen deficiency rather than to the underlying diagnosis. Patients with a history of fracture had significantly lower bone density than those without a history of fracture. Ten patients had suffered an apparently atraumatic fracture. CONCLUSIONS--Amenorrhoea in young women should be investigated and treated to prevent bone mineral loss. Menopausal women with a past history of amenorrhoea should be considered to be at high risk of osteoporosis.

https://www.bmj.com/content/bmj/301/6755/790.full.pdf

Bone mineral loss in young women with amenorrhoea.

A comparative, randomized study of low-dose human menopausal gonadotropin and follicle-stimulating hormone in women with polycystic ovarian syndrome

Uterine growth in the follicular phase of spontaneous ovulatory cycles and during luteinizing hormone-releasing hormone-induced cycles in women with normal or polycystic ovaries

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Uterine growth in the follicular phase of spontaneous ovulatory cycles and during luteinizing hormone-releasing hormone-induced cycles in women with normal or polycystic ovaries