Maternal serum androgens in human pregnancy: early increases within the cycle of conception

Previous studies have demonstrated elevations in testosterone andandrostenedione initiated within the cycle of conception in pregnantnon-human primates, and minimal data in the human support the same picture.In the present study we have investigated a group of patients scheduled forartificial insemination with regular menstrual cycles. For this study allpatients provided blood samples at 5 days after the luteinizing hormone(LH) surges and daily through the luteal phase and into early pregnancy (n= 12). Patients who did not become pregnant served as normal controls (n =9). We have measured 17- hydroxyprogesterone (17-OHP) as a marker of lutealactivity not obscured by progesterone within the cycle of conception andtestosterone and androstenedione as the major androgens. There were nosignificant changes in testosterone and androstenedione in the non-pregnant controls, but both testosterone and androstenedione weresignificantly elevated in the pregnant luteal phase, with the firstincreases occurring at 15 and 14 days respectively after the LH surge.Three of 12 pregnant patients did not demonstrate a dramatic increase ineither testosterone or androstenedione and when examined more carefully acorresponding lack of increase in 17-OHP in those same subjects indicatedless than optimal luteal activity, suggesting that these androgens wereproducts of the corpus luteum. In three subjects in which consecutivenon-pregnant and pregnant cycles were followed there was a dramaticincrease from the non-pregnant luteal phase to the pregnant luteal phaseindicating that the more important observation may be the concentrations ofandrogens in the conceptive luteal phase compared to some baseline, eitherprevious luteal phase or even follicular phase. We have also studiedchanges in dehydroepiandrosterone sulphate and found that there was nosignificant contribution to this increase in androgens in early conception.These studies demonstrate a significant increase in both testosterone andandrostenedione presumably of ovarian, specifically luteal, origin and thatadrenal androgen production is not a factor in these changes.