Altered balance between the 5 alpha-reductase and aromatase pathways of androgen metabolism during controlled ovarian hyperstimulation with human menopausal gonadotropins.
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.
Slater
C C
CC
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
Chang
L
L
Stanczyk
F Z
FZ
Paulson
R J
RJ
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
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