Inappropriate gonadotropin secretion in polycystic ovary syndrome

ObjectiveTo evaluate inappropriate gonadotropin secretion in women with polycystic ovary syndrome (PCOS).DesignRetrospective study.SettingAcademic tertiary center.Patient(s)A total of 373 women were classified into three groups: [1] healthy control women (n = 48); [2] women who were positive for PCOS risk factor; and [3] women with PCOS (n = 251).Intervention(s)None.Main Outcome Measure(s)Gonadotropin levels, LH-FSH ratio, body mass index, and clinical and/or biochemical presentations of PCOS.Result(s)The area under the receiver operating characteristic curve, used to predict PCOS for the LH-FSH ratio, showed similar diagnostic performance to total T and average ovarian volume. The LH-FSH ratio exhibits greater observed accuracy than total T and average ovarian volume for evaluation of women with oligomenorrhea or anovulation. An LH-FSH ratio of >1 presented the best combination of sensitivity and specificity. Body mass index was positively correlated with total T in non-PCOS and PCOS groups; however, body mass index was negatively correlated with LH in PCOS but showed no correlation in non-PCOS subjects.Conclusion(s)The LH-FSH ratio is a valuable diagnostic tool in evaluating women with PCOS and oligomenorrhea or anovulation, and an LH-FSH ratio of >1 may be used as a decision threshold. The link between body mass index and LH may provide clues for further understanding the pathological milieu of PCOS.