TESTOSTERONE, A FOLLICULAR REGULATOR - KEY TO ANOVULATION

To study the interrelationships of steroids within the follicle, combi ned 6-h infusions of [H-3]dehydroepiandrosterone sulfate and [C-14] te stosterone ([C-14]T) were performed in four normal women treated with menotropins who were undergoing medically indicated surgery. The conce ntrations of tracer and/or nonisotopic dehydroepinadrosterone sulfate, androst-5-ene-3beta,17beta-diol sulfate, androst-5-ene-3beta,17beta-d iol, dehydroepiandrosterone, androstenedione, T, dihydrotestosterone, estrone (E1), and estradiol (E2) were determined in arterial and venou s blood and follicular fluid. The log-transformed product/precursor ra tio of [H-3]dihydrotestosterone/[H-3]T in follicular fluid was negativ ely correlated with the log-transformed follicular concentrations of E 1 (P = 0.01) and E2 (P = 0.02), suggesting a reciprocal relationship b etween 5alpha-reductase and follicular E1 and E2. E2 and T were positi vely correlated in follicular fluid (r = 0.84; P = 0.0003), suggesting a stimulatory action of follicular T on aromatase. These findings alo ng with extensive published data suggest that follicular T functions a s a follicular regulator, enhancing follicular aromatase activity when adequate amounts of FSH are available. These conclusions have importa nt implications with regard to mechanisms for selecting the dominant f ollicle and producing atresia in the remaining cohort of follicles, an d they describe a final common path in the pathophysiology of anovulat ion.