Androgenic response in anovulatory women during menotropins stimulation

Menotropins (human menopausal gonadotropin [hMG]) are used to induce follicular maturation and ovulation in anovulatory infertile women. To determine how hMG stimulation affected ovarian androgen production during such therapy, plasma androstenedione (A) and testosterone (T) levels were measured at the beginning and end of hMG therapy in 5 patients with anovulatory hypogonadotropism (group 1) and 15 patients with anovulatory polycystic ovary syndrome (group 2). Mean pretreatment levels of plasma estradiol (E2), T, and A were significantly higher in group 2 compared with group 1. Stimulation with hMG caused E2 levels to reach the same maximum value in both groups. Testosterone levels increased from 0.2 +/- 0.03 ng/ml (mean /+- SE) to 0.4 %/- 0.038 ng/ml for group 1 patients, and from 0.53 +/- 0.06 ng/ml to 0.8 +/- 0.1 ng/ml for group 2 patients. Androstenedione levels increased from 1.5 +/- 0.47 ng/ml to 2.1 +/- 0.4 ng/ml and from 4.37 +/- 0.77 ng/ml to 5.8 +/- 1.1 ng/ml in groups 1 and 2, respectively. The influence of hMG on plasma androgen levels was studied in women who received several treatment cycles before they became pregnant. In these women plasma androgen levels reached the same values in all cycles, including the final cycle in which the patient became pregnant. The data indicate that patients treated with hMG become pregnant despite marked gonadal androgen production. These observations suggest that hMG therapy promotes steroidogenesis in both the granulosa and theca cells of the follicle.