1999 Fiscal Year Final Research Report Summary
Prediction of the presence of follicles and development of individualized therapy in premature ovarian failure based on clinical and basic studies
| Project/Area Number |
10671533
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Shiga University of Medical Science |
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Principal Investigator |
TAKAKURA Kenji Shiga University of Medical Science, Associate Professor, 医学部, 助教授 (10221350)
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| Project Period (FY) |
1998 – 1999
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| Keywords | premature ovarian failure / FSH / inhibin / ovulation induction / follicle |
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| Research Abstract |
Objectives Premature ovarian failure (POF) is a hypergonadotropic hypogonadism manifested by secondary amenorrhea in women under 40 years of age. For POF patients who have wish for a baby, it is indispensable to predict the presence of ovarian follicles. If the patient has no follicles, she has no chance to conceive except for the oocyte donation.
Design and Methods Response of serum LH and FSH levels to E/P administration and serum inhibin levels were determined in 24 POF patients. They were compared retrospectively between ovulatory patients and anovulatory patients.
Results Cases with relatively high levels of serum inhibin showed an increase of serum estradiol level during suppression of gonadtropin secretion by estrogen/progestogen (E/P) or GnRH agonist administration. Thus, it was suggested that serum inhibin measurement may be a useful functional indicator of the presence of follicles. In fact, inhibin levels in the ovulatory group were significantly indicator of the presence of follicles. In fact, inhibin levels in the ovulatory group were significantly higher than those in the anovulatory group (inhibin, 1.19 and 0.29 ; α-β inhibin A, 1.20 and 0.29U/ml, respectively). The degree of decrease in basal gonadotropin levels during E/P or increase of serum estradiol levels after E/P administration may be also a useful indicator of the presence of follicles. In the ovulatory group (n=8) serum levels of FSH during E/P administration were significantly lower than those in the anovulatory group (n=16) (6.4 and 20.2 mlU/ml, respectively). Cyclic E/P therapy was successful in ovulation induction in 25% of idiopathic POF patients, which is similar to GnRH agonist / hMG therapy. Cyclic E/P therapy was more favorable in bone and lipid metabolism and financial cost than GnRH agonist / hMG therapy.
Conclusions Response of serum FSH levels to E/P administration and serum inhibin determination may be useful to predict the presence of ovarian follicles in POF patients.
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