Outcome of corticotropin stimulation testing in women with androgen excess and ovulatory dysfunction.

Abstract

Our objective was to evaluate women with clinical signs or chemical evidence of androgen excess by corticotropin stimulation testing. Seventy-six women with evidence of androgen excess were evaluated by corticotropin stimulation testing. Results were examined by plasma levels of dehydroepiandrosterone sulfate, androstenedione, and testosterone. Conception in those infertile women with androgen excess was also assessed. Data were evaluated with Fisher's exact test. Of 41 women with dehydroepiandrosterone sulfate levels greater than 2.8 micrograms/ml, 17 (41.5%) had a positive corticotropin stimulation test (stimulated 17 alpha-hydroxyprogesterone value exceeded baseline value by 2.7 times). No statistically significant association was found between androstenedione or testosterone excess and a positive corticotropin stimulation test. In 14 infertile women with dehydroepiandrosterone sulfate levels greater than 2.8 micrograms/ml and a positive corticotropin stimulation test, 7 (50%) conceived when given low-dose prednisone (p less than 0.005). Corticotropin stimulation testing is warranted in women with clinical signs of androgen excess and dehydroepiandrosterone sulfate levels greater than 2.8 micrograms/ml.