Variations of steroid hormone metabolites in serum and urine in polycystic ovary syndrome after nafarelin stimulation: evidence for an altered corticoid excretion

To evaluate the clinical relevance of testing pituitary-ovarian re-sponses in patients suffering from polycystic ovary syndrome (PCOS) with the GnRH agonist nafarelin, a 1.2-mg dose of nafarelin was given intranasally to 19 women with PCOS and 15 healthy premenopausal women. The subsequent analysis of steroids in both serum and urine during the test was carried out at several time points for up to 24 h. Serum levels of 17a-hydroxyprogesterone were elevated at all time points of the test in PCOS patients US. controls [at baseline, 3.5?0.2vs. 1.8t0.1nmol/L(P<0.001);at24h,9.9~0.9us.4.9~ 0.3 nmoVL (P < O.OOl)]. Basal levels of androstenedione were higher in the patient group, but there was no significant change during the test in either group. Serum testosterone levels were also found to differ in PCOS patients compared with the control values at baseline (2.2? 0.2 us. 1.5 2 0.1 nmol/L; P < 0.05) and after nafarelin treatment (at 24 h, 3.2-t 0.4 us. 1.8 2 0.2 nmol/L; P < 0.05). Serum estradiol levels ros