Ovarian morphology and pituitary gonadotrophins in serum during and after long-term treatment with oral contraceptives.

Abstract

Abstract. The aim of the present investigation was to directly correlate the development of ovarian follicles with the levels of FSH and LH in serum during long‐term treatment with oral contraceptives in order to discover to what extent follicular maturation beyond the stage of early primary follicles depends upon stimulation with pituitary gonadotropins.Seventeen women aged 20 to 44 were treated cyclically for 6 to 100 months with different oral contraceptives of the combination type. Group I (10 women) were examined during treatment, while group II (7 women) were examined within the first 7 weeks after cessation of treatment. Laparotomy was performed in all cases, and FSH and LH in serum were determined radioimmunologically shortly before the operation. The ovaries were inspected macroscopically, and large wedge excisions were submitted to histological examination.During treatment the values of serum FSH were low, but within the normal range in all women. The values of serum LH were very low in the normal range or even below the lower limit. The number of primordial follicles seemed to be mainly dependent on the age of the individual woman, whereas no correlation with the duration of treatment was found. All women except one revealed primary follicles in different stages of development. More surprising was the fact that 5 out of the 10 women showed antral and/or Graafian follicles in spite of the low levels of FSH and LH. No fresh corpora lutea were found. Two women showed a slight thickening of tunica albuginea, but in no case was perifollicular fibrosis found.Within the first 7 weeks after treatment 6 out of the 7 women revealed antral and/or Graafian follicles, and 2 of them a fresh corpus luteum. In addition, all values of FSH and LH in serum were within the normal range, and significantly higher than during treatment.