Figure 1. Estrogen and testosterone metabolism pathway.
Maternal estrogens and testosterones are cholesterol-derived hormones that are primarily synthesized from maternal cholesterol in the ovaries, adrenal glands, and adipose tissue (to a lesser extent) in the first trimester. The maternal-fetal-placental unit become the primary producer of hormones after the first trimester. Estrogens and testosterones are metabolized in the maternal liver, and the parent compounds as well as resulting metabolites are excreted in urine. The bolded compounds are the eight major urinary estrogen and two major urinary testosterone parent compounds or metabolites measured in this study. DHEA, dihydroepiandrostenediene; DHEAS, dihydroepiandrostenediene sulfate.