Increased luteinizing hormone pulse frequency in obese oligomenorrheic girls with no evidence of hyperandrogenism Richard Y. Yoo, M.D., Asheesh Dewan,

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Increased luteinizing hormone pulse frequency in obese oligomenorrheic girls with no evidence of hyperandrogenism Richard Y. Yoo, M.D., Asheesh Dewan, M.D., Reshmi Basu, B.S., Ron Newfield, M.D., Michael Gottschalk, M.D., R. Jeffrey Chang, M.D. Fertility and Sterility Volume 85, Issue 4, Pages 1049-1056 (April 2006) DOI: 10.1016/j.fertnstert.2005.09.037 Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

FIGURE 1 Distribution of LH pulse frequency per 24 hours among girls with PCOS, with oligomenorrhea (Oligo), and in normal girls. Menstrual cycle study dates are signified by filled circles (cycle days 5–9) and open circles (cycle days 2–4) for the normal group. The bar indicates the mean value in each group. Yoo. LH pulse frequency and oligomenorrhea. Fertil Steril 2006. Fertility and Sterility 2006 85, 1049-1056DOI: (10.1016/j.fertnstert.2005.09.037) Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

FIGURE 2 Pulsatile 24-hour LH secretion in a normal girl (gynecological age, 2.5 years; Tanner stage 5); a girl with PCOS (gynecological age, 3 years; Tanner stage 5); and an adolescent with oligomenorrhea (gynecological age, 4 years; Tanner stage 5). The horizontal bar represents sleep time. Yoo. LH pulse frequency and oligomenorrhea. Fertil Steril 2006. Fertility and Sterility 2006 85, 1049-1056DOI: (10.1016/j.fertnstert.2005.09.037) Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

FIGURE 3 Number of LH pulses during sleep (filled circles) and while awake (open circles) among individual normal adolescent girls. Early follicular and midfollicular correspond to cycle days 2–4 and 5–9 of the menstrual cycle, respectively. Yoo. LH pulse frequency and oligomenorrhea. Fertil Steril 2006. Fertility and Sterility 2006 85, 1049-1056DOI: (10.1016/j.fertnstert.2005.09.037) Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions

FIGURE 4 Mean (±SE) 17-OHP levels at baseline (open bars) and 24 hours after (solid bars) Lupron injection in girls with PCOS, with oligomenorrhea (Oligo), and in normal girls. aP<.05 vs. normal; *P<.01; **P<.001. Yoo. LH pulse frequency and oligomenorrhea. Fertil Steril 2006. Fertility and Sterility 2006 85, 1049-1056DOI: (10.1016/j.fertnstert.2005.09.037) Copyright © 2006 American Society for Reproductive Medicine Terms and Conditions