Incidence of Elevated LH/FSH Ratio in Polycystic Ovary Syndrome Women with Normo- and Hyperinsulinemia

Purpose: The aim of this study was to determine the incidence of abnormal LH/FSH ratio in women with polycystic ovary with normo- and hyperinsulinemia and to assess the influence of elevated LH/FSH ratio on selected endocrine and biochemical parameters.

Material And Methods: One hundred nineteen polycystic ovary syndrome women in reproductive age hospitalized between 1996 and 2000 in Division of Infertility and Reproductive Endocrinology at Poznan University of Medical Sciences were selected for the study. In all selected women LH and FSH serum levels were determined and LH/FHS ratio was calculated. These groups became the subject of a detailed clinical, hormonal and metabolic analysis, which was performed between 6th and 10th day of a natural or induced menstrual period.

Results: LH/FSH ratio greater than 2 was accepted as abnormal, and it was found in 54 women (45.4%; I group). Normal gonadotropin ratio was detected in 65 women (55%; group II). Statistically significant differences were noted between groups with normal and elevated LH/FSH ratio in the following parameters: BMI (body mass index), serum insulin, and LH levels. Further analysis revealed that the majority of women with elevated insulin concentrations belong to the group with normal LH/FSH ratio.

Conclusions: LH/FSH ratio is not a characteristic attribute of all PCOS women: in the present study this abnormality was detected in a subpopulation smaller than 50%. Most of the PCOS women with normal gonadotropin ratio belong to a group of patients suffering from hyperinsulinemia and obesity. Patients with hyperinsulinemia and excess of LH constitute a selected and distinct subgroup with increased adrenal androgenic activity.