A PILOT-STUDY OF THE HUMAN CHORIONIC-GONADOTROPIN TEST FOR OVARIAN HYPERANDROGENISM

A controlled clinical study was designed to investigate the value of h uman chorionic gonadotrophin (HCG) challenge as a test for functional ovarian hyperandrogenism. Dexamethasone administration was followed by 5000 IU HCG and blood samples for steroid hormone assay were obtained 0, 8, 16 and 24 h thereafter. Study subjects were normal women (n = 1 3); women with functional ovarian hyperandrogenism, defined by androge n excess, amenorrhoea and an increased 17-hydroxyprogesterone response s of 17-hydroxyprogesteron, androstenedione and testosterone to HCG in women with functional ovarian hyperandrogenism were significantly gre ater than in normal women. However, the 17-hydroxyprogesterone respons e to HCG in functional ovarian hyperandrogenism was significantly lowe r after HCG than after nafarelin. The oestradiol response was also sig nificantly lower after HCG than nafarelin, although oestradiol concent ration more than doubled in normal women as well as in women with func tional ovarian hyperandrogenism. The responses to HCG confirm that fun ctional ovarian hyperandrogenism abnormalities are luteinizing hormone (LH)-dependent. Therefore, the 17-hydroxyprogesterone response to HCG could represent a useful test for the diagnosis of ovarian hyperandro genism. The lower 17-hydroxyprogesterone response to HCG than to nafar elin in functional ovarian hyperandrogenism suggests that a follicle-s timulating hormone (FSH)-responsive factor modulates thecal 17-hydroxy progesterone secretion. The oestradiol response to HCG is consistent w ith HCG directly stimulating the oestradiol secretion by thecal cells.