The Polycystic Ovary. III. Steroid Biosynthesis in Normal and Polycystic Ovarian Tissue1

Abstract

Ovarian tissue from one normal subject and from 9 patients with polycystic ovarian disease was incubated with progesterone-4-C-14, 5-pregnenolone-4-C-14, testosterone-4-C-14 or 19-hydroxyandrostene dione. In normal tissue, 17-hydroxylation, 20-ketone reduction, side-chain cleavage, formation of subsequent 19-hydroxy and 19-aldo metabolites and aromatization to estradiol-17β were demonstrated. In the polycystic tissue, deficiencies of aromatization, 17-hydroxy lation and 3β-ol dehydrogenase activity were found. This resulted in a failure to synthesize estrogen and in an accumulation of testosterone, dehydroepiandrosterone and other C₁₉ metabolites. These disorders only partially explain the associated clinical findings, and it is not known whether they are primary defects, secondary to extra-ovarian influences, or a combination of the two.