[Studies on the ovarian pathophysiology by exogenous gonadotropin stimulation in combination with adrenal suppression...

In order to investigate the steroidogenesis of dysfunctional ovaries, adrenal suppression and ovarian stimulation tests were performed on 32 patients with ovulatory defect and 3 volunteers with normal menstrual cycles. The protocol of this study was as follows; 3 mg of dexamethasone (DXM) was given daily for 11 days. From 5th day of DXM, 225 IU of human menopausal gonadotropin (hMG) was injected for 3 days, followed by 5,000 IU of human chorionic gonadotropin (hCG). Serum estrone (E1), estradiol (E2), androstenedione (A), dehydroepiandrosterone (DHA), testosterone (T) and dihydrotestosterone (DHT) were measured by radioimmunoassay. In the patients with polycystic ovaries (PCO) which was confirmed under laparotomy and biopsy, serum E2 levels were markedly elevated by hMG stimulation. The E1 levels were similarly elevated by hMG stimulation and increased further by hCG stimulation. The A levels were significantly high (p less than 0.05), and increased remarkably by hCG. The T levels were very high. And they decreased to 2/3 of the basal level following DXM administration, and they increased again by hCG stimulation. Similar secretion patterns of these steroids in PCO patients were also seen in controls and in some patients with moderately atrophic ovaries (MA). THe secretion pattern of DHA suggested that DHA was also secreted from the PCO, normal ovary and MA ovary. From these results it is presumed that excessive production of androgens is not specific in PCO, but it is the result of continuous intrinsic LH stimulation.