Ann Clin Case Rep | Volume 4, Issue 1 | Clinical Video | Open Access

Diagnosis of Cushing Syndrome during an Infertility Evaluation

Amanda R Schwartz1, Lauren Gratian2 and Thomas M Price1*

1Department of Obstetrics and Gynecology, Duke University, USA
2Department of Internal Medicine, Duke University, USA

*Correspondance to: Thomas M Price 

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Many cases of Cushing’s disease or syndrome are diagnosed after progression of initial non-specific symptoms including weight gain, hirsutism, mood changes and hypertension. In this unusual case, abnormality of the cortisol axis was considered after finding a low level of the adrenal androgen precursor, dehydroepiandrosterone sulfate, during an infertility evaluation for anovulation. Low dehydroepiandrosterone sulfate proved secondary to decreased pituitary adrenocorticotropin hormone production from hypercortisolism associated with an adrenal adenoma. Although dehydroepiandrosterone sulfate levels naturally decline with aging, abnormally low levels should raise suspicion for Cushing’s syndrome.


Cushing’s syndrome; Infertility; Ovulatory dysfunction; Amenorrhea; Dehydroepiandrosterone sulfate


Schwartz AR, Gratian L, Price TM. Diagnosis of Cushing Syndrome during an Infertility Evaluation. Ann Clin Case Rep. 2019; 4: 1664.

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