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Aetiology and Pathomechanism of Folliculo-Luteal Insufficiency

  • György Siklósi
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Abstract

To investigate the causes and pathogenesis of folliculo-luteal insufficiency (FLI), we compared the different clinical and hormonal features of cycles with physiological or deficient folliculo-luteal function. The weight and body mass index (BMI) (kg/m2) of patients with FLI were significantly (p < 0.001) higher, and serum cortisol and prolactin levels were also significantly (p < 0.001) increased when compared to physiological cycles. Serum androgen levels (testosterone, free testosterone, androstenedione, DS) were elevated significantly (p < 0.001) compared to the physiological level only when FLI was associated with hirsutism (12.2 %).

As a result of low-dosage corticoid treatment (continuous administration of 0.5 mg dexamethasone every evening), average luteal P underwent a significant (p < 0.001) increase – it almost doubled (10.8 and 21.0 ng/ml) – and the level of prolactin decreased significantly (p < 0.001) to a physiological level, along with the suppression of all androgens. These effects could be observed in cases both with and without hirsutism.

The clinical and hormonal features observed in FLI and the effectiveness of low-dosage corticoid treatment both support that stress and extreme BMI values (BMI <18.5 and >25.0) play an essential role in the development of FLI, which is primarily mediated through the increased activity of the hypothalamic-pituitary-adrenal axis. The observed beneficial effect of low-dosage corticoid treatment in FLI also means a new, simple and effective treatment possibility of FLI.

Keywords

Endometrial Thickness Serum Prolactin Level Unexplained Infertility Preovulatory Follicle Serum Androgen 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • György Siklósi
    • 1
  1. 1.Semmelweis University Second Department of Obstetrics and GynecologyBudapestHungary

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