Human Reproduction, Vol 12, 1416-1420, Copyright © 1997 by Oxford University Press
SG Levrant, RB Barnes and RL Rosenfield
A controlled clinical study was designed to investigate the value of human
chorionic gonadotrophin (HCG) challenge as a test for functional ovarian
hyperandrogenism. Dexamethasone administration was followed by 5000 IU HCG
and blood samples for steroid hormone assay were obtained 0, 8, 16, and 24
h thereafter. Study subjects were normal women (n = 13); women with
functional ovarian hyperandrogenism, defined by androgen excess,
amenorrhoea and an increased 17-hydroxyprogesterone response to nafarelin
(n = 6); and normal men (n = 4). The responses of 17-hydroxyprogesterone,
androstenedione and testosterone to HCG in women with functional ovarian
hyperandrogenism were significantly greater than in normal women. However,
the 17-hydroxyprogesterone response to HCG in functional ovarian
hyperandrogenism was significantly lower after HCG than after nafarelin.
The oestradiol response was also significantly lower after HCG than
nafarelin, although oestradiol concentration more than doubled in normal
women as well as in women with functional ovarian hyperandrogenism. The
responses to HCG confirm that functional ovarian hyperandrogenism
abnormalities are luteinizing hormone (LH)-dependent. Therefore, the 17-
hydroxyprogesterone response to HCG could represent a useful test for the
diagnosis of ovarian hyperandrogenism. The lower 17- hydroxyprogesterone
response to HCG than to nafarelin in functional ovarian hyperandrogenism
suggests that a follicle-stimulating hormone (FSH)-responsive factor
modulates thecal 17-hydroxyprogesterone secretion. The oestradiol response
to HCG is consistent with HCG directly stimulating the oestradiol secretion
by thecal cells.
ARTICLES
A pilot study of the human chorionic gonadotrophin test for ovarian hyperandrogenism
Department of Obstetrics/Gynecology, University of Chicago, Pritzker School of Medicine, Illinois, USA.
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