title: Altered balance between the 5 alpha-reductase and aromatase pathways of androgen metabolism during controlled ovarian hyperstimulation with human menopausal gonadotropins.
abstract: OBJECTIVE
  To evaluate androgen production and metabolism during controlled ovarian hyperstimulation.
  
  
  METHODS
  Five women, aged 33-42, were studied. All participants were undergoing controlled ovarian hyperstimulation with gonadotropin-releasing hormone agonist and human menopausal gonadotropins. Serum estradiol, estrone, androstenedione, testosterone, 3 alpha-androstanediol glucuronide, and sex hormone-binding globulin levels were measured at 6 time points during the cycle.
  
  
  RESULTS
  The levels of all steroids increased significantly from baseline during controlled ovarian hyperstimulation. Mean total testosterone levels increased from 0.29 +/- 0.05 ng/mL to 0.58 +/- 0.07 ng/mL after gonadotropin stimulation. Sex hormone-binding gonadotropin levels increased from 50 +/- 16 nM to 73 +/- 12 nM after gonadotropin stimulation. Estrone/androstenedione and estradiol/testosterone ratios, reflecting the aromatase pathway, increased whereas 3 alpha-androstanediol glucuronide/androstenedione and 3 alpha-androstanediol glucuronide/testosterone ratios, reflecting 5 alpha-reductase activity, decreased.
  
  
  CONCLUSIONS
  Controlled ovarian hyperstimulation with human menopausal gonadotropins results in increased serum testosterone and androstenedione levels. Whereas there is an enhancement in androgen metabolism by aromatase, 5 alpha-reductase activity with regard to androgen metabolism is diminished.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. coulam@hsc.usc.edu
authors.forename: C C
authors.initials: CC
authors.lastname: Slater
authors.forename: L
authors.initials: L
authors.lastname: Chang
authors.forename: F Z
authors.initials: FZ
authors.lastname: Stanczyk
authors.forename: R J
authors.initials: RJ
authors.lastname: Paulson
mesh_terms: D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase / Q000378:metabolism*; D000328:Adult; D015113:Androstane-3,17-diol / Q000096:biosynthesis / Q000097:blood; D000735:Androstenedione / Q000096:biosynthesis* / Q000097:blood; D001141:Aromatase / Q000378:metabolism*; D004958:Estradiol / Q000096:biosynthesis / Q000097:blood; D004970:Estrone / Q000096:biosynthesis / Q000097:blood; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006062:Gonadotropins / Q000008:administration & dosage; D006801:Humans; D010062:Ovulation Induction; D011247:Pregnancy; D012738:Sex Hormone-Binding Globulin / Q000032:analysis / Q000096:biosynthesis; D013739:Testosterone / Q000096:biosynthesis* / Q000097:blood
chemical_list: D006062:Gonadotropins; D012738:Sex Hormone-Binding Globulin; D015113:Androstane-3,17-diol; D004970:Estrone; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol; C083781:LHRH, Ala(6)-Gly(10)-ethylamide-; D001141:Aromatase; D013741:3-Oxo-5-alpha-Steroid 4-Dehydrogenase