Polycystic ovarian syndrome and pregnancy

The paper describes a case of polycystic ovarian syndrome (PCOS) characterised by normal blood insulin levels and LH hypersecretion which explains the etiopathogenesis of the two voluminous ovarian masses originating from micro-cysts existing prior to pregnancy and undergoing abnormal growth during gestation owing to stimulation by beta-HCG (beta human chorionic gonadotropin). The ability of HCG ti stimulate ovarian steroidogenesis in pregnancy can result in enhanced testosterone and androstenedione levels. Our findings, like those of another recent report, emphasise the correlation between beta-HCG levels and testosterone values; the quantitative increase in beta-HCG probably plays an essential part in determining the abnormal development of the ovarian cysts, which remained morphologically unchanged up to delivery. Our patient's virilisation is explained by the increase in total testosterone in circulation. Fetal virilisation cannot be assessed in this patient because the mother gave birth to a male.