Testosterone production with hydatidiform moles--in vitro and in vivo studies

Fresh molar tissues obtained from seven patients were incubated in vitro with dehydroepiandrosterone and androstenedione. The testosterone concentration in molar tissue ranged from 5.4 ng/g wet weight to 43.8 ng/g wet weight. Both precursors were readily converted to testosterone indicating that 17-hydroxysteroid dehydrogenase and 3beta-hydroxysteroid dehydrogenase are present in molar trophoblast. A 50 mg dose of dehydroepiandrosterone was infused into patients with hydatidiform mole before and after uterine evacuation. There was a testosterone peak preceding an oestrogen rise which disappeared after uterine evacuation. It is suggested that the elevated testosterone level in molar pregnancy is mainly due to the conversion of dehydroepiandrosterone in the molar trophoblast.