The clinical features, ovarian pathology, and hormonal responses to dexamelhasone (Dex), Dex plus; clhinyl cstradiol (HE), and Dex plus; hCG were compared in 5 women with polycyslic ovarian disease (PCOD) who have normal 24-hr urinary luteinizing hormone (LH) levels to 5 who had elevated urinary LH levels. No differences were noted in the clinical features. There was no correlation between ovary size and LH levels. Three in the normal-LH group had hyperthecosis. Plasma androstenedione (A) was more frequently elevated in the high- LH group. Dex plus; EE markedly increased LH secretion in the high-LH group, suggesting increased responsiveness of the positive feedback control mechanism of LH secretion in the high-LH group. There was a greater response of A, testosterone (T), and 17-ketosteroids to Dex plus; hCG in the normal-LH group. Those with high-LH levels did not exhibit a significant increase in A, T, and 17-KS with hCG. The limitations and usefulness of the Dex -r hCG test are discussed. The hypothesis is advanced that the increased LH secretion in the high-LH group is due at least in part to positive feedback resulting from the increased A levels. The amount of 17beta;-oxidoreductasc activity in the ovary may influence LH secretion in PCOD.
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