OVARIAN INFLUENCE ON ADRENAL ANDROGEN SECRETION IN POLYCYSTIC-OVARY-SYNDROME

Objective: To determine whether the ovary influences adrenal androgen secretion in polycystic ovary syndrome (PCOS). Design: The adrenal androgen secretion was evaluated before and during ovarian suppression with a long-acting GnRH agonist. Setting: Department of Obstetrics and Gynecology, Pisa, Italy. Participants: Women with PCOS and high (10 subjects) and normal (12 subjects) DHEAS levels and 6 normal women. Interventions: After 1 mg dexamethasone, an ACTH-(1-24) stimulation test was performed in the early follicular phase of the menstrual cycle. The test was repeated after two injections of a long-acting GnRH analogue (GnRH-a). Main Outcome Measures: Basal plasma levels of gonadotropins, E(2), T, androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), DHEAS, and cortisol (F) were evaluated before the evening administration of dexamethasone. Serum A, T, 17-OHP, DHEAS, and F were measured 9 hours after dexamethasone and in samples collected 60 and 120 minutes after ACTH IV injection. Results: In the high DHEAS group the maximum increases in T, A, 17-OHP, and DHEAS in response to ACTH were significantly higher than in normal DHEAS PCOS women and in normal women. The GnRH-a modified the A and T responses to ACTH in the high DHEAS group. Conclusions: Ovarian steroids, or other extra-ovarian factors, seem to be responsible for the increased A and T responses to the corticotropin stimulation demonstrated in some PCOS women.