Fazli Subhan, Faheem Tahir, Sikandar Sultan, Fariyal Deepa, Birjees Mazhar Kazi, Athar Saeed Dil.
A study on the relationship of gonadotropins during the follicular and luteal phases among the Pakistani married women.
Pak J Med Res Jan ;42(4):188-90.

Objective: The serum concentrations of FSH and LH, as well as LH/FSH and FSH/LH ratios were determined among female subjects, in order to observe the synergistic effect of the gonadotropins (LH and FSH) during the follicular as well as the luteal phases of the menstrual cycle. Method: The subjects (n=142) were divided initially into follicular phase and luteal phase, and then further into another seven and four groups, respectively, upon the basis of various combinations formed depending on the normal, hypo and hyper secretion of either one, or both, of these gonadotropins. Levels of LH and FSH were evaluated at the Reproductive Physiology/Health laboratories, using EIA technique. Statistical Analysis: Data representing age as well as the hormonal levels, were statistically analyzed by application of the students `t` test. Results: In follicular phase, serum concentration of LH and FSH were within normal range in 42 subjects and the mean LH/FSH and FSH/LH ratios in this group were 1.17 ± 0.10 and 0.85±0.10, respectively. In case of normal LH and low FSH concentrations (n=2), these ratios were, 2.95± 0.68 and 0.33±0.17 while in the case of normal LH and high FSH (n=9), the respective ratios were 0.28±0.04 and 3.45±0.77. In case of low LH and normal FSH concentrations (n=4), mean ratios of LH/FSH and FSH/LH were 0.09±0.08 and 10.36±0.64, while in case of low LH and FSH concentration (n=2), the ratios were 0.94±0.16 and 1.02±0.19, respectively, while in the subjects with high LH and normal FSH concentrations (n=24), these ratios were 3.17±0.57 and 0.31±0.07 and case of patients having an elevation of both LH and FSH (n=16), the respective ratios were 0.81±0.050 and 1.23±1.10. Among the follicular phase subjects, no significant differences (p>0.05) were observed with the normal group in case of both the ratios when the two gonodropins were having an identical picture, while in all other combinations, both LH/FSH and FSH/LH ratios differed significantly (p<0.05). In the luteal phase, 31 subjects exhibited normal LH and FSH levels, with mean LH/FSH and FSH/LH ratios being 1.70±0.20 and 0.58±0.10. In the group comprising of patients with normal LH and high FSH (n=5), the ratios were 0.51±0.13 and 1.97±0.38, respectively, while for subjects with high LH and normal FSH (n=5), the respective ratios were 6.22±1.80 and 0.16±0.30 and in case of both LH and FSH being high (n=5), the ratios were 0.96±0.10 and 1.05±0.14, respectively. In the luteal phase, both the ratios in all patient groups differed significantly (p<0.05) from the normal group. Conclusion: The present study seems to indicate that disturbance of any one of the gonadotropins, which results in variation of the gonadotropin ratios, may cause infertility.

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