Plasma testosterone and androstenedione levels during monitored induction of ovulation in infertile women with 'simple' amenorrhoea and with the polycystic ovary syndrome.

Twenty-seven infertile patients with 'simple' amenorrhoea-oligomenorrhoea and eighteen with the polycystic ovary (PCO) syndrome were treated for induction of ovulation with clomiphene, human menopausal gonadotrophin and human chorionic gonadotrophin. The treatment was monitored by plasma oestradiol, testosterone, androstenedione and progesterone estimation. Women with PCO had significantly higher plasma androgen levels than women with 'simple' amenorrhoea (P less than 0--1 to P less than 0-001) both before treatment and during induction of ovulation. When ovulation was induced the pregnancy rate for women with the PCO syndrome with elevated androgens was 21% while for those with uncomplicated amenorrhoea it was 75%. It is concluded that high levels of circulating androgens might be a factor preventing conception in some patients in whom ovulation is apparently successfully induced.