EVALUATION OF OVARIAN AND ADRENAL SOURCES OF ANDROGENS IN WOMEN WITH POLYCYSTIC-OVARY-SYNDROME - DEXAMETHASONE AND GNRH-AGONIST ADMINISTRATION

Ovarian and adrenal production of androgens was evaluated in 18 patien ts with polycystic ovary syndrome (PCOS) by administrating a combinati on of short-term dexamethasone (DEX) and long-term gonadotropin-releas ing hormone agonist (GnRH-A). At day 6 of the cycle, blood samples wer e collected at 7 A.M. (basal) and 11 P.M. At midnight, 2 mg DEX was gi ven orally, and blood samples were collected at 7 A.m. the following d ay (DEX1). Blood samples were obtained for 6 weeks at the same time af ter administration of a potent GnRH-A (400 mug/day given subcutaneousl y). Eight normal subjects served as controls. The amounts of androgens and 17-hydroxyprogesterone (17-OHP) suppressed by using DEX (adrenal- source suppression) and GnRH-A (ovarian-source suppression) were great er in PCOS patients than in controls. We differentiated PCOS patients as having a normal or an exaggerated response to DEX or GnRH-A adminis tration; threshold values were considered average +2SD of the suppress ed androgen amounts of controls. Three patients had an exaggerated res ponse to GnRH-A treatment for androstenedione, testosterone and 17-OHP , while DEX inhibition was similar to controls. The remaining 15 patie nts had an exaggerated response to DEX for all three androgens; seven also had an exaggerated response to GnRH-A. Thus, the combination of G nRH-A and DEX permitted us to selectively study and identify adrenal a nd ovarian.sources of hyperandrogenemia.