STEROID STUDIES IN A CASE OF OVARIAN HYPERLUTEINIZATION WITH VIRILISM IN TWO CONSECUTIVE PREGNANCIES

Abstract

ABSTRACT Studies were performed in a woman, who developed virilism in 2 consecutive pregnancies, presumably on the basis of hyperluteinization of both ovaries but without any distinct luteoma. Both pregnancies were terminated by Casearean section. During the first pregnancy a very high concentration of testosterone in the peripheral plasma was found immediately before delivery. During the second pregnancy the patient was followed regularly with determinations of testosterone and androstenedione in the plasma as well as 17-ketosteroids, 17-hydroxycorticosteroids, cortisol, pregnanetriol, pregnanediol and oestriol in the urine. The first 2 trimesters were characterized by a moderate increase in plasma testosterone and androstenedione and of urinary 17-ketosteroids. In the last trimester there was a marked increase in plasma androgens and urinary 17-ketosteroids, corresponding to clinical manifestations of virilism. Thus, at the end of the second pregnancy, the concentration of testosterone and androstenedione in the peripheral plasma was 10 times higher than the values found in normal pregnancy. Even higher values were found in ovarian vein blood and exceedingly high concentrations in ovarian cyst fluid. The administration of chorionic gonadotrophin between the 2 pregnancies resulted in an increase in plasma testosterone and androstenedione whereas menopausal gonadotrophin given in low dosage was without any significant effect.