The origin of androgen synthesis in polycystic ovary syndrome.

The site of androgen synthesis was determined in 21 women with polycystic ovary syndrome on the basis of radiographic studies, catheterization of ovarian and adrenal veins, and/or inferior vena cava samplings. Gradients of testosterone, androstenedione, and dehydroepiandrosterone sulfate were determined by comparing the levels in adrenal and ovarian veins with those found in antecubital veins. In six patients, the adrenals were the predominant site of androgen synthesis. In five patients, both the ovaries and adrenals participated equally in androgen production. A good correlation was observed between the results obtained from gonadal and adrenal vein catheterizations and dynamic studies using stimulation with pregnyl and inhibition with dexamethasone. The results point to the important role of adrenals and ovaries in androgen overproduction. Stimulation and inhibition tests were in agreement with catheterization data. No correlation was found between morphology and hormonal disturbances.