ABSTRACT
The excretion of urinary pregnane-3α,20α-diol and that of pregnane-3α,17α,20α-triol was investigated in thirty-three patients with the polycystic ovary syndrome. The method utilized for the quantitation of these metabolites involved enzymatic hydrolysis of urines followed by solvent extraction, alumina column chromatography of the crude neutral extract, acetylation of the diol and triol fractions with acetic anhydride-1-14C, paper chromatography of the acetoxy derivatives and measurement of the 14C activity on the chromatographic paper strip by the aid of a radio-chromatogram scanner equipped with an integrating recorder. It was found that during the control period, patients with the polycystic ovary syndrome excreted amounts of metabolites comparable to that found in normal women during the proliferative phase. Under stimulation with human chorionic gonadotrophin the polycystic ovary syndrome patients failed to exhibit the rise in urinary pregnanediol found in normal subjects. After bilateral ovarian wedge resection, there was a return to normal menstrual cycles and normal fluctuations in the urinary excretion of pregnanediol and pregnanetriol. It has been concluded that pregnanediol and pregnanetriol excretion in these patients corresponds to that of normal women during the proliferative phase. Exogenous HCG does not produce the increase in urinary excretion corresponding to the secretory phase as it does in normal women. Ovarian wedge resection re-establishes the normal pattern of cyclic variations in urinary excretion.