Hyperreactio luteinalis (HRL) is rarely observed in normal pregnancy. Its clinical spectrum consists of benign development of often bilateral lutein cysts and may be revealed by an overproduction of androgens. HRL is more often in relation with an excessive production of human chorionic gonadotropin (hCG) either in trophoblastic disease or in hyperplacentosis (Rh-alloimmunization or diabetes), but in 60% of the cases HRL may occur in normal singleton pregnancies. Many benign or malignant ovarian lesions can mimic HRL during pregnancy. The pathophysiology of HRL in singleton pregnancies involves an increased sensitivity of ovarian stromal cells to hCG. A positive ovarian stimulation test with hCG, recommended three months after delivery may detect a recurrence risk for further pregnancies. Conservative treatment is advised and surgery must be reserved for maternal complications.
Adult Androgens