Efficacy of chronic therapy with the gonadotrophin releasing hormone agonist decapeptyl in patients with polycystic ovary syndrome.

Our objective was to assess the endocrine and morphological response of polycystic ovary syndrome (PCOS) in patients receiving 6 months of therapy with the long-acting gonadotrophin releasing hormone agonist (GnRH agonist) decapeptyl (3.75 mg monthly injections). Eighteen documented PCOS patients were basally evaluated for hirsutism, gonadotrophin and androgen concentrations and ovarian morphology using trans-vaginal ultrasonography. Measurements were repeated at 3 and 6 months. The results (values as mean +/- SD) showed a significant improvement in hirsutism (Ferriman score 11.0 +/- 5.9 versus 6.6 +/- 2.7, P < 0.01), acne and seborrhoea. A significant post-treatment decrease in gonadotrophins [follicle-stimulating hormone (FSH): 5.8 +/- 1.8 versus 3.8 +/- 1.1 IU/l, P < 0.01; luteinizing hormone (LH): 10.8 +/- 8.3 versus 3.4 +/- 3.3 IU/l, P < 0.01], LH/FSH ratio (1.8 +/- 1.1 versus 0.8 +/- 0.6, P < 0.01) and androgen concentrations (free testosterone: 4.0 +/- 1.9 versus 1.9 +/- 0.7 pg/ml, P < 0.01, delta 4-androstenedione: 3.9 +/- 1.2 versus 1.9 +/- 0.6 ng/ml, P < 0.001) was also found, while oestradiol approximated castration concentrations (68.4 +/- 29.5 versus 29.1 +/- 6.7 pg/ml, P < 0.001). Finally, mean ovarian volume (19.7 +/- 6.2 versus 10.9 +/- 4.6 cm3, P < 0.001), capsule thickness (2.5 +/- 0.8 versus 1.9 +/- 0.7 mm, P < 0.05) and stromal density dropped significantly, as did uterine volume (34.2 +/- 10.5 versus 19.9 +/- 8.9 cm3, P < 0.01). In conclusion, treatment of our PCOS patients for 6 months with the GnRH agonist decapeptyl proved efficient in inducing significant clinical, biochemical and ovarian morphological improvement.