Usefulness of serial measurements of serum follicle stimulating hormone, luteinizing hormone and estradiol in patients with premature ovarian failure.

This study tests the hypothesis that serial measurements of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) are useful in identifying a subset of patients with premature ovarian failure (POF) who may respond to high-dose human menopausal gonadotropin (hMG) therapy. Nineteen patients with POF were studied with weekly measurements of serum FSH, LH, and E2 for five consecutive weeks. Nine patients (group I) showed episodic increases in E2 (greater than 50 pg/ml), seven accompanied by decreases in FSH, and an FSH/LH ratio that was periodically less than 1.0. Ten patients (group II) displayed persistent, nonvarying low E2 and high FSH and LH levels. There was no significant difference in the E2 response to high-dose hMG (48 to 100 ampules hMG/trial) in the two groups, all patients failing to respond. In conclusion, serial assays for FSH, LH, and E2 in patients with POF fail to predict ovarian responsiveness to a trial of high-dose hMG.