Androgen responses to adrenocorticotropic hormone infusion among individual women with polycystic ovary syndrome

Objective: To compare androgen responses during ACTH infusion among women with polycystic ovary syndrome (PCOS) and healthy women. Design: Cross-sectional study. Setting: Academic medical center. Patient(s): Women with PCOS (n = 13) and healthy controls (n = 15). Intervention(s): Blood samples were obtained frequently during a 6-hour dose-response ACTH infusion. Main Outcome Measure(s): Comparison of basal and stimulated levels of 17 alpha-hydroxyprogesterone (17-OHP), androgens, and cortisol (F) during ACTH infusion with those after hCG injection within individual subjects. Result(s): In women with PCOS increased 17-OHP, androstenedione (A), and DHEA responses during ACTH infusion were comparable to those observed in healthy controls. The magnitude of responses was highly variable among women with PCOS. Within individual women with PCOS adrenal responses to ACTH and ovarian responses to hCG were significantly correlated. Cortisol responses to ACTH were similar in women with PCOS and healthy controls. Conclusion(s): Within individual women with PCOS, enhanced androgen responses to ACTH are accompanied by comparable androgen responsiveness to hCG. These findings suggest that dysregulated steroidogenesis leading to hyperandrogenemia in this disorder is likely present in both adrenal and ovarian tissues. Clinical Trial Registration Number: NCT00747617. (Fertil Steril (R) 2016;106:1252-7. (C) 2016 by American Society for Reproductive Medicine.)