Ovarian steroidogenesis in japanese patients with polycystic ovary syndrome.

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Abstract
Gonadotropin and steroid hormone levels in both peripheral and ovarian venous blood were measured in samples obtained from 20 Japanese patients with polycystic ovary syndrome (PCO) and 10 normal women in early follicular phase (normal women) by radioimmunoassay. The change in the amount of steroid hormone following i.v. human menopausal gonadotropin (HMG) or dexamethasone administration was investigated. The mean concentration in patients with PCO was significantly higher than the concentrations found in normal women for LH [lutropin] (P < 0.001), but not for FSH [follitropin] in peripheral blood. Significantly elevated ovarian venous steroid hormone levels in PCO were found for 17.alpha.-hydroxypregnenolone (P < 0.05), progesterone (P < 0.05), 17.alpha.-hydroxyprogesterone (P < 0.01), 4.DELTA.-androstenedione (P < 0.01), testosterone (P < 0.01), estrone (P < 0.01) and estradiol (P < 0.05), but not for dehydroepiandrosterone sulfate (DHEAS). The ovarian dehydroepiandrosterone (DHEA) level was slightly elevated in PCO. The concentration of ovarian 4.DELTA.-androstenedione in PCO reached twelve times as much as that in normal women. After the HMG administration, all of the ovarian venous steroid hormone levels were elevated slightly and without significance in the short observation time for 10 min. The DHEAS level was suppressed while the ovarian DHEA level remained high in PCO following dexamethasone administration. Apparently, there is no adrenal involvement and no adrenal-like component in the ovary of PCO, and no evidence of 3.beta.-hydroxysteroid dehydrogenase and/or aromatase deficiency in this study. The increase in the steroid hormone secretion in PCO is explained by the increase in ovarian production in polycystic enlarged ovaries.

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