Polycystic ovarian disease

Abstract Forty patients with a diagnosis of polycystic ovarian disease (Stein-Leventhal syndrome) are presented. All were subjected to ovarian wedge resections which resulted in ovulatory cycles in 36. Thirty-seven pregnancies occurred in 21 patients. All had normal excretory rates for estrogen and gonadotropin. 17-Ketosteroid levels were normal or slightly elevated. In those cases tested, pregnanetriol values were all within normal limits. Pregnanediol levels were comparable to those found during the follicular phase of a normal menstrual cycle. In 2 patients LH excretion was comparable to that found in three normal patients during the pre- and postovulatory phases. A third patient had slightly greater LH levels. Cystic ovaries were produced experimentally in rats by several methods which permitted continuous exposure of the ovaries to FSH without sufficient LH for ovulation and luteinization. Analysis of these clinical and experimental data provides a possible explanation for the production of polycystic ovaries and the usually favorable response to ovarian wedge resections. These observations suggest that the Stein-Leventhal syndrome is but a part or phase of the over-all problem of anovulatory ovarian function.