Serum Progesterone Concentration is Raised during Early Follicular Phase in Women with Polycystic Ovaries

Abstract

Polycystic ovaries (PCO), identified by ultrasonography, may be present in as many as 23% of otherwise normal women not manifesting any of the clinical signs of obesity, hirsutism and oligomenorrhoea.' Furthermore, a third of women being investigated for infertility in a recent study were shown to have PCO by laparocopy.^ Thus this condition would appear to be far more common than hitherto suspected, and could account for a large proportion of infertility cases. The condition is usually associated with elevated concentrations of LH and androgens, including testosterone,' but some indices such as free androgen index may be influenced by factors such as age and obesity4 and LH concentrations are not always raised.The ovaries and the adrenal glands are the main sources of androgens in women. Increased stimulation of the ovaries by LH during the follicular phase could account for raised androgen concentrations, in which case precursor progestogens should also be increased. Late onset congenital adrenal hyperplasia due to mild (subclinical) 2 1 a-hydroxylase deficiency might also result in increased concentrations of progesterone and I7a-hydroxyprogesterone, some of which would be converted to androgens. Since low dose progestogen pills can be used t o reduce fertility in normal women, it is possible that raised endogenous progestogen concentrations in women with PCO during the follicular phase could contribute to their infertility.We have compared serum progesterone, 17a-hydroxyprogesterone and various androgen indices during the early part of the follicular phase in women with PCO and in women with normal ovaries, since during this part of the cycle the concentrations of these steroids are normally low. METHODSSeventeen young female medical students initially volunteered to take part in the study which had Medical Ethical Committee approval. All the women underwent abdominal ultrasonography, and were subsequently classified as negative (n = 10) or positive (n = 7) for the presence of polycystic ovaries using the criteria of Adams et u I .~ A blood sample was taken between days 1-5 of the cycle from each subject and the steroid concentrations subsequently determined using standard radioimmunoassay techniques.The hormones measured were progesterone, 1 7a-hydroxyprogesterone, androstenedione, dehydroepiandrosterone sulphate and testosterone. In addition, sex hormone binding globulin (SHBG) concentrations were determined, and the ratio of testosterone to SHBG expressed as a percentage to give a value for the free androgen index (FAI). All samples for progesterone and 17a-hydroxyprogesterone were measured in the same batch. The within-assay coefficient of variation for progesterone at 1.039nmol/L was 12% while that for 17a-hydroxyprogesterone at 1.003 nmol/L was 24%.One woman, classified as having normal ovaries was subsequently found to have concentrations of hormones all well above those measured for the rest of the group. She was diagnosed as a probable late onset congenital adrenal hyperplasia and was not included i...

Induction by Estradiol-17β of Polycystic Ovaries in the Guinea Pig1

“…P levels also were similar between EV-treated rats and controls [22]. In a study of women with PCO, serum progesterone and 17cr-hydroxyprogesterone concentrations were significantly elevated in the early follicular phase, a point in the cycle when these steroids are normally low [23]. Studies with monkeys demonstrated that four E 2 capsules administered on Day 6 of the cycle for a period of 24 h resulted in a significant reduction in P production by granulosa cells in vitro as well as in reduced P in the follicular fluid (FF) of the dominant follicle, but no change in serum P [5].…”

Reproductive Performance of Rahmani Ewes in Breeding and Non-Breeding Seasons Aaccording to Different Hormonal Protocols

“…Plasma was packed in labeled plastic tubes and stored at -20 o C until assayed later for progesterone (P4) concentration. Concentration of P4 was determined based on competition reaction (Bojanic et al, 1991) on samples of five selected ewes (3 ewes responde to lambing and one or two non-responded ewes) of each treatment group.…”

Estrus Synchronization in Ewes Using Sponges With PMSG or Ram Effect With or Without Progesterone Injection

“…1188 manufactured by Immunotech, France). The assay is based on competition reaction (Bojanic et al, 1991).…”