The pathogenesis of ovarian dysfunction was studied in ten female patients with chronic renal failure treated with regular hemodialysis. Their ages ranged 20 - 37 years. Another ten healthy adult females served as controls, their ages ranged 23 to 35 years. Assessment of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin and estradiol (E,) in serum was done. Clomiphene stimulation test to FSH and was also done in a random group of 7 dialyzed patients. Serum FSH, LH and (E2) in dialyzed patients were comparable to those found in normal women during the follicular phase of the menstrual cycle.
In al! patients, there was an absence of cyclicity. After clomiphene, serum levels of LH and FSH rose significantlv suggesting that the negative E2 feedback, the tonic gonadotropin secretion and the pituitary ovarian axis were normal. The positive E2 feedback associated with cyclic release of LH was impaired as indicated by the prevalence of acyclicity and absence of ovulation. Hyperprolactinemia in dialyzed group may inhibt ovarian function at multiple levels along hypothalamic pituitary ovarian axis. |
