Hum. Reprod. Advance Access originally published online on September 9, 2004
Human Reproduction 2004 19(12):2742-2747; doi:10.1093/humrep/deh512
Patterns of hormonal response to the GnRH agonist leuprolide in brothers of women with polycystic ovary syndrome: a pilot study
1 Laboratory of Endocrinology, Department of Medicine, San Juan de Dios Hospital, School of Medicine, University of Chile and 2 Laboratory of Animal Physiology and Endocrinology, School of Veterinary Medicine, University of Concepción, Chillán, Chile
3 To whom correspondence should be addressed at: Laboratory of Endocrinology, Department of Medicine W. Division, School of Medicine, Las Palmeras 299, Interior Quinta Normal, Casilla 33052, Correo 33, Santiago, Chile. Email: tsir{at}med.uchile.cl
BACKGROUND: The aim of this study was to evaluate the effect of a single dose of leuprolide acetate on gonadotrophin and gonadal steroid secretion in brothers of women with polycystic ovary syndrome (PCOS), in order to assess P450c17
activity. An oral glucose tolerance test (OGTT) and a lipid profile were also performed. METHODS: Twenty-two unrelated brothers of women with PCOS (PCOSb) and 14 brothers of normal cycling women (Cb), matched for age, underwent a leuprolide acetate test (10 µg/kg s.c.) and an OGTT with measurement of circulating concentrations of gonadotrophins, steroid hormones, glucose, insulin and lipids. RESULTS: Clinical and basal hormonal parameters were similar in both groups. After leuprolide administration, PCOSb exhibited a significant increase of 17
-hydroxyprogesterone (17-OHP) compared to Cb (P<0.05). However, only 45% of PCOSb showed a supranormal increase of 17-OHP (2 SD above the respective control group mean values, P<0.003) with a normal gonadotrophin response (group 1). The other 55% of the PCOSb exhibited a normal 17-OHP response to the analogue (group 2). However, in group 2, basal steroid concentrations did not show a uniform pattern: six of the PCOSb exhibited high basal androstenedione (2 SD above the respective control group mean values), three were very similar to Cb, and the other three presented lower basal testosterone concentrations (2 SD below the respective control group mean values) than those observed in Cb. CONCLUSIONS: This study shows that different responses to leuprolide in PCOS brothers make evident the heterogeneity of this syndrome in which P450c17
activity could be involved.
Key words: GnRH agonist/male phenotype/polycystic ovary syndrome
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