Adrenal function in infertile women

Abstract

The influence of adrenal function on the menstrual cycle and infertility is still unclear. Therefore an ACTH stimulation test was routinely performed in 156 women with fertility problems who attended the Fertility Center of the Women’s Hospital in Heidelberg between 1 January 1986 and 30 June 1986. 46 of these patients served as controls (C) and fulfilled the following criteria: 25 to 35 years old, normal weight, no hirsutism, no acne, biphasic cycles, normal basal concentrations of FSH, LH, prolactin, TSH and TSH after 200 μg TRH, no medication, no chronic illness. 36 of them had had tubai ligation after previous uneventful pregnancies and desired refertilisation, while 10 of them had a check-up before heterologous insemination. 36 additional paid volunteers were chosen in the same manner. During days 2-5 of the menstrual cycle, ACTH testing was performed between 8 and 9 a.m. From an indwelling catheter three blood samples were drawn in 15-min-intervals and pooled for determination of the basal concentrations of 17-hydroxypregnenolone (170H-Preg), 17-hydroxyprogesterone (170HP), cortisol, 21-deoxycortisol (21-DF), dehydroepiandrosterone (DHEA) and its sulfate (DHEA-S), androstenedione (A), testosterone (T) and dihydrotestosterone (DHT). 60 and 120 min after an intravenous injection of 250 μg ACTH, additional blood samples were taken. All hormones were determined by radioimmunoassays, partly after Chromatographie separation. The Table gives the upper limit (95th percentile) of the basal and stimulated hormone concentrations in C(n = 82).