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BART C. J. M. FAUSER, THIERRY D. PACHE, STEVEN W. J. LAMBERTS, WIM C. J. HOP, FRANK H. DE JONG, KRISTINE D. DAHL, Serum Bioactive and Immunoreactive Luteinizing Hormone and Follicle-Stimulating Hormone Levels in Women with Cycle Abnormalities, with or without Polycystic Ovarian Disease, The Journal of Clinical Endocrinology & Metabolism, Volume 73, Issue 4, 1 October 1991, Pages 811–817, https://doi.org/10.1210/jcem-73-4-811
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Serum steroid, gonadotropin, and α-subunit levels were assessed in 35 women with cycle abnormalities [11 with and 24 without polycystic ovarian disease (PCOD) according to strict clinical and biochemical criteria] and 8 regularly cycling women in the early (cycle day 3 or 4) and mid (cycle day 7 or 8) follicular phase. LH and FSH levels were estimated using two immunological techniques [RIA and immunoradiometric assay (IRMA)] and in vitro bioassays (BIO), using mouse Leydig cells and rat granulosa cells, respectively. In PCOD patients mean α-subunit, free androgen index [FAI; testosterone × 100/sex hormone-binding globulin (SHBG)], androstenedione, estrone, and estradiol (E2) were significantly elevated compared to levels in the early follicular phase of control cycles and non-PCOD patients. In addition, in PCOD patients mean IRMA-LH and RIALH levels were distinctly increased (2.8- to 3.6 fold, respectively; both comparisons, P < 0.001) compared to control values, but in the same order of magnitude (1.3- to 1.4-fold increments) as that in non-PCOD patients. However, the median BIO-LH level in PCOD patients was 5.9-fold higher than that in non-PCOD patients and 4.0-fold higher than the BIO-LH in the early follicular phase of control women. Consequently, the median BIO/IRMA-LH ratio was 4.8-fold higher in PCOD patients compared to non-PCOD patients. In women with cycle abnormalities, individual BIO/IRMA-LH ratios correlated with BIOLH (r8 = 0.48), FAI (r8 = 0.39), free estrogens (E2/SHBG ratios; r8 = 0 0.47), and dehydroepiandrosterone sulfate (r8 = 0.60) concentrations. Mean IRMA-, RIA-, and BIO-FSH levels and BIO/IRMA-FSH ratios were not significantly different when various groups were compared. Although RIA- and IRMA-LH levels showed good correlation (r8 = 0.88), RIA-LH levels were consistently higher, resulting in distinctly higher RIA-LH/FSH ratios (mean, 4.5) compared to IRMA-LH/FSH ratios (median, 1.8) in PCOD patients.
The results presented in this study indicate: 1) there were no differences in mean serum levels of IRMA-FSH, RIA-FSH, and BIO-FSH when comparing PCOD, non-PCOD patients, and controls; 2) the LH/FSH ratio estimated by IRMA in PCOD patients is substantially lower than that measured by RIA (IRMA may not be useful to identify PCOD patients); 3) free α-subunit levels in PCOD patients are elevated compared to those in controls and non-PCOD patients; 4) BIO/IRMA-LH ratios in PCOD patients are significantly increased compared to those in non-PCOD patients; and 5) in women with cycle abnormalities, BIO/IRMA-LH ratios are correlated with FAI, E2/SHBG ratios, and dehydroepiandrosterone sulfate levels.
