Cited by 301Ovarian function and disordersReproductive Biology and FertilityAdrenal Hormones and Disorders

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Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome

Gilling‐Smith, C., Story, H, Rogers, V., Franks, S.·1997·Clinical Endocrinology

DOI 10.1046/j.1365-2265.1997.2321049.x

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Abstract

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a common endocrinopathy of unknown aetiology. The aims of this study were to identify whether ovarian thecal cell steroidogenesis is abnormally regulated in PCOS by measuring steroid responses to a single dose of hCG before, and during, suppression of endogenous LH levels by GnRH analogue (GnRHa). DESIGN: Serum levels of LH, FSH, 17 alpha hydroxyprogesterone (17OHP), androstenedione, testosterone and dehydroepiandrosterone sulphate were measured before, and 48 hours after, a single intramuscular injection of 10,000 IU hCG. The test was repeated 4 weeks after suppression of endogenous LH levels by GnRHa. PATIENTS: The ovarian responses to hCG were compared in three groups of women. Eleven women had normal ovaries and regular cycles, eight had polycystic ovaries but not clinical features of the syndrome (PCO group) and eight had polycystic ovaries, anovulation and either severe hirsutism or alopecia (PCOS group). RESULTS: Before GnRHa treatment, LH levels were significantly higher in the PCOS group but hCG stimulated a similar rise in 17OHP in all three groups. Following analogue, LH levels were suppressed in all three groups but the 17OHP responses to hCG were significantly higher in both the PCO and PCOS groups compared with normal controls. CONCLUSIONS: These findings provide further evidence in favour of an intrinsic abnormality of thecal cell steroidogenesis in the polycystic ovary.

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Single-Cell RNA-Seq Identifies Pathways and Genes Contributing to the Hyperandrogenemia Associated with Polycystic Ovary Syndrome
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Androstenedione induces abnormalities in morphology and function of developing oocytes, which impairs oocyte meiotic competence
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Akram, T., Hasan, S., Imran, M., Karim, A., & Arslan, M. (2009) · Gynecological Endocrinology · doi:10.3109/09513590903159565 · Cited by 19
Beta endorphin in serum and follicular fluid of PCOS- and non-PCOS women
Jaschke, N., Lunger, F., Wildt, L., & Seeber, B. (2018) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-018-4793-6 · Cited by 15
“reported about a primary dysfunction of ovarian steroidhormone synthesis in PCOS women [2].”
Background
Adipose-androgen crosstalk in polycystic ovary syndrome: mechanisms and therapeutic implications
Ni, M., Lei, H., Ye, T., & Wang, Y. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1731179 · Cited by 25
Third Annual World Congress on the Insulin Resistance Syndrome
Bloomgarden, Z. T. (2006) · Diabetes Care · doi:10.2337/dc06-zb09 · Cited by 16
“Women with PCOS have increased LHstimulated androgen production (38,39), which improves with insulin sensitizing intervention (40); metformin, rosiglitazone, and the combination of both have similar effects in decreasing testosterone levels in PCOS (41).”
Background
Epilepsy and the ovary (cutting out the hysteria)
Betts, T., Dutton, N., & YARROW, H. (2001) · Seizure · doi:10.1053/seiz.2001.0561 · Cited by 16
POLYCYSTIC OVARY SYNDROME: ORIGINS AND IMPLICATIONS: Polycystic ovary syndrome: the impact of androgen excess on metabolic health
Cussen, L., McDonnell, T., Miller, C., McIlroy, M., & O’Reilly, M. (2025) · Reproduction · doi:10.1530/rep-25-0102 · Cited by 19
Participação dos androgênios adrenais na síndrome dos ovários policísticos
Gil-Junior, Â. B., Rezende, A. P. R., Carmo, A. V., Isaías, É. D., de Medeiros, M. M. W. Y., & de Medeiros, S. F. (2010) · Revista Brasileira Ginecologia e Obstetrícia · doi:10.1590/s0100-72032010001100005 · Cited by 15
Analysis of gonadotropin pulsatility in hirsute women with normal menstrual cycles and in women with polycystic ovary syndrome
Minanni, S. L., Marcondes, J. A. M., WAJCHENBERG, B. L., Cavaleiro, A. M., Fortes, M. A. H. Z., Rego, M. A., Paranaguá‐Vezozzo, D. C., Robard, D., & Giannella‐Neto, D. (1999) · Fertility and Sterility · doi:10.1016/s0015-0282(98)00514-7 · Cited by 14
The Search for the Causes of Common Hyperandrogenism, 1965 to Circa 2015
Rosenfield, R. L. (2024) · Endocrine Reviews · doi:10.1210/endrev/bnae007 · Cited by 16
Relationship Between 17-Hydroxyprogesterone Responses to Human Chorionic Gonadotropin and Markers of Ovarian Follicle Morphology in Women With Polycystic Ovary Syndrome
Maas, K. H., Chuan, S. S., Cook‐Andersen, H., Su, H.-C. I., Dulęba, A. J., & Chang, R. J. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-2956 · Cited by 14
“Subsequent in vivo studies demonstrated that suppression of endogenous gonadotropin secretion by GnRH agonist failed to alter the magnitude of 17-hydroxyprogesterone (17-OHP) and androgen responses to human chorionic gonadotropin (hCG) in women with PCOS, whereas in normal women these responses were minimal (11).”
Background
The role of chronic inflammation and Leu55Met PON1 polymorphism in the pathogenesis of polycystic ovary syndrome
Lenarcik, A., Bidzińska−Speichert, B., & Tworowska-Bardzińska, U. (2010) · Gynecological Endocrinology · doi:10.3109/09513591003686387 · Cited by 15
“The etiopathogenesis of PCOS has not been definitively determined, although it is known that defective androgen synthesis and metabolism in the ovaries [3,4], neuroendocrine disorders leading to abnormal lutropin (LH) secretion [3,5], as well as abnormal insulin secretion and function and related insulin resistance [6…”
Background
Polycystic ovary syndrome: a new ultrasonographic and color Doppler pattern
Battaglia, C., Regnani, G., Artini, P. G., et al. (2000) · Gynecological Endocrinology · doi:10.3109/09513590009167713 · Cited by 14
Does metformin affect ovarian morphology in patients with polycystic ovary syndrome? A retrospective cross-sectional preliminary analysis
Falbo, A. I., Orio, F., Venturella, R., Rania, E., Materazzo, C., Tolino, A., Zullo, F., & Palomba, S. (2009) · Journal of Ovarian Research · doi:10.1186/1757-2215-2-5 · Cited by 15
“However, few reports from the previous studies [7,10-13] suggested that this finding is often associated to abnormal gonadotropin levels, lower levels of insulin growth factorbinding protein-1 (IGF-BP1), increased insulin resistance and increased ovarian 17-hydroxiprogesterone (17-OHP) and androgen responses to gonado…”
Background
Polycystic Ovary Syndrome and the Neuroendocrine Consequences of Androgen Excess
Silva, M. S. B., & Campbell, R. E. (2022) · Comprehensive physiology · doi:10.1002/cphy.c210025 · Cited by 22
Ibuprofen Reduces Testosterone Level in Women With Polycystic Ovary Syndrome
Banaszewska, B., Ożegowska, K., Polska, M., Pawelczyk, L. A., Chang, R. J., & Dulęba, A. J. (2022) · Journal of the Endocrine Society · doi:10.1210/jendso/bvac128 · Cited by 14
“While the pathophysiology of this syndrome is still poorly understood, the central feature of PCOS is excessive production of androgens by ovarian theca cells [5].”
Background
Achieving a Successful Pregnancy in Women with Polycystic Ovary Syndrome
Araki, T., Elias, R. T., Rosenwaks, Z., & Poretsky, L. (2011) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2011.08.003 · Cited by 13
PHYSIOLOGY AND ENDOCRINOLOGY SYMPOSIUM: Insulin action and lipotoxicity in the development of polycystic ovary syndrome: A review1
Faubert, J., Battista, M., & Baillargeon, J. (2016) · Journal of Animal Science · doi:10.2527/jas.2015-0089 · Cited by 12
CYP17 T/C (rs74357) gene polymorphism contributes to polycystic ovary syndrome susceptibility: evidence from a meta-analysis
Liu, X., Xu, M., Qian, M., & Yang, L. (2021) · Endocrine Connections · doi:10.1530/ec-21-0327 · Cited by 13
Current Developments in the Molecular Genetics of the Polycystic Ovary Syndrome
Franks, S., Gharani, N., Waterworth, D. M., Batty, S., White, D. M., Williamson, R., & McCarthy, M. I. (1998) · Trends in Endocrinology and Metabolism · doi:10.1016/s1043-2760(98)00018-6 · Cited by 13
Self-citation
Metformin and polycystic ovary syndrome
Lebinger, T. G. (2007) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e328089f0ea · Cited by 13
Insulin Action in Polycystic Ovary Syndrome: In Vivo and In Vitro
Baillargeon, J. (2007) · Springer eBooks · doi:10.1007/978-0-387-69248-7_4 · Cited by 12
“Increased ovarian androgen responsiveness was demonstrated in vivo in women with PCOS using GnRH agonists or human chorionic gonadotropin (hCG) stimulation tests [17].”
BackgroundMethod
Ovarian response to the human chorionic gonadotrophin stimulation test in normal ovulatory women: the impact of regressing corpus luteum
Järvelä, I. Y., Niinimäki, M. J., Martikainen, H. K., et al. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.08.114 · Cited by 12
Le syndrome des ovaires polykystiques en période péri-pubertaire : polymorphisme clinique, biologique, métabolique et génétique
Trimeche, S., Dieudonne, J.-F. T. D., Jeandel, C., Paris, F., Brum, I. S., Orio, F., & Sultan, C. (2003) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2003.10.027 · Cited by 12
The Pathogenesis of the Polycystic Ovary Syndrome: A Hypothesis
Gabrilove, J. L. (2002) · Endocrine Practice · doi:10.4158/ep.8.2.127 · Cited by 12
In-vitro ovarian steroidogenesis in women with pelvic congestion
Gilling‐Smith, C., Mason, H. D., Willis, D., et al. (2000) · Human Reproduction · doi:10.1093/humrep/15.12.2570 · Cited by 12
Self-citation

Authors: Gilling‐Smith, C., Story, H., Rogers, V., & Franks, S.
Affiliations: St Mary's Hospital (GB)
Corresponding author: Gilling‐Smith, C.
ORCID: Franks, S.
Venue: Clinical Endocrinology
Publisher: Wiley
Published: 1997-07
Volume: 47
Issue: 1
Pages: 93-99
ISSN: 0300-0664 (ISSN-L)
1365-2265
DOI: 10.1046/j.1365-2265.1997.2321049.x
OpenAlex: W2141227160
Cited by: 301
References: 0
Citations by year: 2026: 3 · 2025: 11 · 2024: 11 · 2023: 5 · 2022: 15 · 2021: 10 · 2020: 8 · 2019: 12 · 2018: 8 · 2017: 5 · 2016: 4 · 2015: 5 · 2014: 13 · 2013: 16 · 2012: 16
FWCI: 8.74
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 2311 d)
Locations: Clinical Endocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: Bayer Corporation
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords: polycystic ovary syndrome, hCG stimulation test, 17-hydroxyprogesterone, GnRH analogues, LH suppression, androstenedione, testosterone, dehydroepiandrosterone sulfate, hirsutism, anovulation
MeSH terms: Adolescent, Adult, Androstenedione, Female, Chorionic Gonadotropin, Gonadotropins, Pituitary, Humans, Luteinizing Hormone, Gonadotropin-Releasing Hormone, Middle Aged, Polycystic Ovary Syndrome, Gonadal Steroid Hormones, Testosterone, Theca Cells, Dehydroepiandrosterone Sulfate, 17-alpha-Hydroxyprogesterone

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Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome

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