ABSTRACT
Two men with primary infertility after 6 to 11 years of marriage were found to have isolated follicle-stimulating hormone deficiency syndrome (IFDS). Their endogenous gonadotropin secretion was compared with that of two other infertile men with hypothalamic disease (Kallmann's syndrome) and pituitary tumor with hyperprolactinemia. Treatment with intramuscular gonadotropin was given to produce circulating and 24-hour urine levels of luteinizing hormone and follicle-stimulating hormone at or above the upper limit of the normal male range to ensure continued gonadal stimulation. Sperm counts increased in IFDS men within 6 to 26 weeks, with maximum total sperm counts of 33.5 and 20 million after 9 to 80 weeks. Pregnancy occurred after 20 weeks' therapy in one patient's wife with the subsequent delivery of a normal male infant. IFDS may be a treatable cause of male infertility given adequate gonadotropin therapy.
Subject(s)
Chorionic Gonadotropin/therapeutic use , Follicle Stimulating Hormone/deficiency , Infertility, Male/etiology , Menotropins/therapeutic use , Adult , Follicle Stimulating Hormone/analysis , Humans , Hypothalamic Diseases/complications , Hypothalamic Diseases/drug therapy , Infertility, Male/drug therapy , Luteinizing Hormone/analysis , Male , Pituitary Neoplasms/complications , Pituitary Neoplasms/drug therapy , Prolactin/blood , Sex Hormone-Binding Globulin/analysis , Sperm Count , Spermatogenesis/drug effects , Time FactorsABSTRACT
We developed polarization fluoroimmunoassays for 11-deoxycortisol in serum and saliva. To avoid interfering factors, the steroid was initially extracted from the biological fluids with dichloromethane. Assays could then be completed without any further separation procedures or need to correct for blank signals. The serum assay was suitable for following the response to the metyrapone test and results correlated acceptably with those by an established, specific, direct 125I-radioimmunoassay. The method is not sufficiently sensitive to detect 11-deoxycortisol in normal saliva, but greatly increased concentrations were found in post-metyrapone saliva and results agreed well with those by the radioimmunoassay as modified for salivary assay. Salivary 11-deoxycortisol assay would provide a convenient means of monitoring results of the metyrapone test.
Subject(s)
17-Hydroxycorticosteroids/analysis , Cortodoxone/analysis , Metyrapone/metabolism , Saliva/analysis , Cortodoxone/blood , Cortodoxone/isolation & purification , Cross Reactions , Fluorescence Polarization , Fluorescent Antibody Technique , Humans , Methylene Chloride , Radioimmunoassay , Saliva/metabolismABSTRACT
Polarisation fluoroimmunoassays for serum and salivary cortisol were developed using the steroid labelled at the 3-position with fluorescein and antiserum raised in sheep. To avoid interfering factors present in the biological fluids, cortisol was extracted with dichloromethane prior to assay, which was then accomplished without the need for any further separation or blank-correction procedures. The methods were sufficiently sensitive to cover the normal morning ranges for serum and salivary cortisol and correlated acceptably with established fluorimetric and radioimmunoassay techniques. The salivary cortisol assay was more precise than the serum assay, reflecting the greater case with which cortisol may be extracted from saliva. The potential usefulness of salivary cortisol assays was illustrated by a preliminary study showing that the circadian variation in three children was similar to that in an adult.
Subject(s)
Hydrocortisone/analysis , Saliva/analysis , Adult , Aging , Child , Child, Preschool , Female , Fluorescence Polarization , Humans , Hydrocortisone/blood , Immunoassay/methods , MaleABSTRACT
Different indexes of thyroid function were determined in conjunction with values obtained with a new commercial radioimmunoassay kit for serum free thyroxin, in 49 apparently healthy subjects, 87 pregnant women, and 142 outpatients attending the thyroid clinic. The results indicate a diagnostic success rate of 88% when free thyroxin was measured instead of estimating the so-called free thyroxin index. Furthermore, in three cases of papillary carcinoma the concentration of free thyroxin was increased, although all the other laboratory tests indicated a euthyroid state. Technically, the method is simple, rapid, and precise, and it would be of most value in the small hospital laboratory lacking the facilities of a comprehensive thyroid-function test service.
Subject(s)
Thyroid Diseases/blood , Thyroxine/blood , Adolescent , Adult , Aged , Binding Sites , Carcinoma, Papillary/blood , Evaluation Studies as Topic , Female , Humans , Middle Aged , Pregnancy , Radioimmunoassay , Reagent Kits, DiagnosticABSTRACT
The determination of cortisol levels in saliva offers a number of significant advantages as compared with plasma or serum measurements, and radioimmunoassay is the technique of choice because of the greater sensitivity required. To date, the assay of salivary cortisol has been limited to only a few centres employing 'in-house' reagents. We describe some simple modifications of a commercial kit, designed for the assay of cortisol in serum and urine, which allow direct and rapid determination of the steroid in saliva. These modifications enable any laboratory with access to a gamma counter to perform large numbers of salivary cortisol assays at relatively low cost.
