Dexamethasone / human chorionic gonadotrophin (hCG) and dexamethasone / nafarelin as a valid diagnostic tests in reproductive aged women with polycystic ovarian syndrome (PCOS)

Hajder, E.; Hajder, M.
March 2010
HealthMed;Mar2010, Vol. 4 Issue 1, p87
Academic Journal
Introduction. Hyperandrogenism is a functional, diagnostic and therapeutic problem of women in reproductive age. The aim of this study was to determine the validity of dexamethasone-human chorion gonadotrophin (DEXA/hCG) and dexamethasone- nafarelin (DEXA/N) testing in the differential hyperandrogenism diagnosis in differentiating polycystiyc ovary syndrome (PCOS) from other forms of hyperandrogenism. Subjects and methods. Prospective study included 30 women of reproductive age with PCOS, selected by diagnostic Rotterdam criteria (group A) and 12 women of reproductive age who are not PCOS (group B). Subgroup A1 (n = 15) and B1 (n = 6) were treated with DEXA/hCG test, subgroups A2 (n = 15) and B2 (n = 6) were treated with DEXA/N test. All respondents had the same parameters: cortisol, dehydroepiandrosterone sulphate (DHEAS), total testosterone, SHBG, free androgen index (FAI) and 17-hydroxyprogesterone (17- OHP) basal, during and after testing. Results: The suppression with dexamethasone during (DEXA /hCG) test in subgroups A1 and B1, the fourth day was followed by a significant decline in average values (p<0.05) DHEAS, testosterone, SHBG, free androgen index (FAI) and 17-OHP in relation to the basal value. After the 5000 IU hCG subgroup A1 was followed by a significant increase 17-OHP (p<0.001), greater than 7 nmol / l, while in subgroup B1 there was significant increase in value (p<0.01) less than 5 nmol/l in relation to the value before giving hCG . In DEXA / N after the suppression test in subgroups A2 and B2 there was a significant decline in average values of (p< 0.05) DHEAS, testosterone, SHBG, FAI and 17-OHP on the fourth day of the test when compared to the basal value. After the injection of nafarelin ampoules of 100 ug in subgroup A2 there was a significant increase in the value of 17-OHP (p<0.001), greater than 7 nmol/l, while the significant increase in subgroup B2 (p<0.01) was 5 nmol /l in relation to the value before injection of nafarelin. Average value of 17- OHP in the DEXA / N test was significantly higher (p<0.001) when compared to the average value of 17-OHP in the DEXA /hCG test in subjects with PCOS. Conclusion: The results of this study showed that DEXA /hCG and DEXA/N are valid tests for the diagnosis of PCOS, but the nafarelin test is more significant.


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