[Fertility disorders in 49 hyperandrogenic women desiring pregnancy. Treatment results aimed at obtaining a pregnancy in 40 hyperandrogenic infertile women and in 9 hyperandrogenic women desiring pregnancy].

The clinical and therapeutic aspects of fertility due to hyperandrogenism were studied in 49 women (40 presenting with sterility and 9 for another reason but seeking to become pregnant). Patients were divided into three main etiological groups on the basis of hormonal findings: ovarian (15 cases), adrenal (16 cases) and mixed (11 cases) hyperandrogenism. This study highlighted several points. 22% of infertile women had no cutaneous signs of hyperandrogenism and menstrual disturbances were missing in 46% of cases of adrenal hyperandrogenism. Primary infertility was seen more often in all types of hyperandrogenism (28 cases) than secondary infertility (12 cases). Secondary infertility was explained by a high early spontaneous abortion rate in hyperandrogenism (40%). This was much commoner in adrenal hyperandrogenism than in ovarian or mixed hyperandrogenism. Inducing treatment based upon a combination of dexamethasone and clomiphene citrate proved to be the most effective in these infertile women (86% pregnancy rate). The frequency of spontaneous abortions in infertility due to ovarian or mixed hyperandrogenism treated by clomiphene citrate alone can probably be explained by the persistence of hyperandrogenism.