Steroidogenesis in hydatidiform mole--sources of androgens

Plasma concentration of testosterone is significantly higher in patients with a molar pregnancy than in those with a normal pregnancy at similar gestation. The source of this raised level of testosterone has been controversial with some suggesting the molar trophoblast while others, the hyperstimulated ovary as the main contributor. We have carried out a series of investigations involving measurements of testosterone levels in plasma before and after evacuation of the uterus and in fluid from molar vesicle and lutein cyst. Furthermore, in vitro study on the conversion of androstenedione and dehydroepiandrosterone (DHEA) to testosterone and in vivo conversion of DHEA to testosterone and oestradiol before and after evacuation of the mole were conducted. Considering all the evidence together, it appears that the hyperstimulated ovary is probably the major source of the raised concentration of testosterone in molar pregnancy. On the other hand, although the molar trophoblast also makes some contribution as in normal pregnancy, the molar trophoblast is essential for the production of oestrogens.