This is a condition where pituitary fails to secrete gonodotropic hormones called FSH & LH.
Normally the ovarian follicle which consist of oocyte (eggs) granulose and theca cell, start producing estrogen (female sex hormone) in response to FSH & LH from pituitary.
As the ovarian follicle grows, blood levels of estrogens rises, this estrogen supplies release of FSH and at a higher level causes LH surge and the follicle rupture, oocyte is released and what remains behind is crumpled granulosa and theca cells form the corpus luteum.
Corpus luteum produces progesterone and its life is for 14 days. So 14 days often ovulation corpus luteum dies – progesterone levels fall – the inner lining of the uterus which was supported by progesterone sheds out as menstruation.
So, for ovulation and menstruation to occur – pituitary FSH &LH are essential.
When pituitary cannot produce FSH&LH – the condition is called Hypogonadotrophic Hypogonadism (HH).
In this condition, women fail to get regular menses. Hypogonadotrophic Hypogonadism (HH) if mild, scanty menses occur at irregular intervals. Hypogonadotrophic Hypogonadism (HH) if severe, women will have no menses at all.
Diagnosis is done by measuring serum FSH & LH levels which are usually less than 1 MIU/ML. Treatment of this condition is very rewarding. In women desiring fertility, ovulation is induced by injection of FSH & LH.
Ovulation is monitored by Transvaginal ultra sound. Pregnancy rates are very high in these patients.