Endocrine Responses to Triptorelin in Healthy Women, Women With Polycystic Ovary Syndrome, and Women With Hypothalamic Amenorrhea.
Endocrine Responses to Triptorelin in Healthy Women, Women With Polycystic Ovary Syndrome, and Women With Hypothalamic Amenorrhea.
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DOI：
10.1210/clinem/dgad026
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发表时间：
2023-06-16
期刊：
影响因子：
--
通讯作者：
Dhillo WS
中科院分区：
文献类型：
--
作者：
Abbara A;Phylactou M;Eng PC;Clarke SA;Pham TD;Ho TM;Ng KY;Mills EG;Purugganan K;Hunjan T;Salim R;Comninos AN;Vuong LN;Dhillo WS
关于多囊卵巢综合征（PCOS）妇女与健康妇女或下丘脑闭经（HA）妇女相比，对促性腺激素释放激素受体激动剂（GnRHa）雷普托雷林的内分泌反应是否不同，目前的数据有限。我们比较了健康女性、多囊卵巢综合征女性、无卵巢刺激的HA患者以及卵巢刺激后接受卵母细胞捐赠周期的多囊卵巢或无多囊卵巢患者的促性腺激素对雷肥素的反应。血清促性腺激素水平的变化是在(1)一项前瞻性单盲安慰剂对照研究中确定的，该研究旨在确定健康女性、多囊卵巢综合征女性和HA患者在没有卵巢刺激的情况下使用雷普陀林（0.2 mg）或盐水安慰剂的内分泌特征；(2)在卵巢刺激后卵母细胞捐赠周期中使用雷普托雷林（0.2-0.4 mg）进行剂量随机对照试验的回顾性分析。在研究1中，雷普陀林诱导所有女性血清黄体生成素（LH）的增加幅度相似（LH平均峰值：健康，52.3；PCOS, 46.2； HA, 41.3 IU/L）。与健康女性和HA患者相比，PCOS患者血清促卵泡激素（FSH）变化的AUC降低（血清FSH变化的中位AUC: PCOS， 127.2；健康女性，253.8；HA, 326.7 IU.h/L; P = 0.0005）。在研究2中，与正常形态卵巢（n = 91）相比，至少有一个多囊卵巢（n = 60）的女性服用雷普托利林后4小时FSH水平降低（34.0 vs 42.3 IU/L; P = 0.0003）。血清抗<s:1>勒氏激素（AMH）与雷普托雷林后FSH的增加呈负相关，无论是否有卵巢刺激。在多囊卵巢患者中，无论是否有卵巢刺激，FSH对雷普雷林的反应都减弱，并且与AMH水平呈负相关。
Limited data exist regarding whether the endocrine response to the gonadotropin-releasing hormone receptor agonist (GnRHa) triptorelin differs in women with polycystic ovary syndrome (PCOS) compared with healthy women or those with hypothalamic amenorrhea (HA). We compared the gonadotropin response to triptorelin in healthy women, women with PCOS, or those with HA without ovarian stimulation, and in women with or without polycystic ovaries undergoing oocyte donation cycles after ovarian stimulation. The change in serum gonadotropin levels was determined in (1) a prospective single-blinded placebo-controlled study to determine the endocrine profile of triptorelin (0.2 mg) or saline-placebo in healthy women, women with PCOS, and those with HA, without ovarian stimulation; and (2) a retrospective analysis from a dose-finding randomized controlled trial of triptorelin (0.2-0.4 mg) in oocyte donation cycles after ovarian stimulation. In Study 1, triptorelin induced an increase in serum luteinizing hormone (LH) of similar amplitude in all women (mean peak LH: healthy, 52.3; PCOS, 46.2; HA, 41.3 IU/L). The AUC of change in serum follicle-stimulating hormone (FSH) was attenuated in women with PCOS compared with healthy women and women with HA (median AUC of change in serum FSH: PCOS, 127.2; healthy, 253.8; HA, 326.7 IU.h/L; P = 0.0005). In Study 2, FSH levels 4 hours after triptorelin were reduced in women with at least one polycystic morphology ovary (n = 60) vs normal morphology ovaries (n = 91) (34.0 vs 42.3 IU/L; P = 0.0003). Serum anti-Müllerian hormone (AMH) was negatively associated with the increase in FSH after triptorelin, both with and without ovarian stimulation. FSH response to triptorelin was attenuated in women with polycystic ovaries, both with and without ovarian stimulation, and was negatively related to AMH levels.
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