The effect of serum prolactin levels on ovarian steroidogenesis.

In order to assess the effect of hyperprolactinemia on ovarian steroidogenetic potential, a group of anovulatory hyperprolactinemic patients and a control group of anovulatory normoprolactinemic women were submitted to exogenous gonadotropin (hMG) stimulation under identical experimental conditions. Serum 17 beta-estradiol (E2) concentrations were determined before and after hMG stimulation. The mean basal serum E2 levels in the hyperprolactinemic group (22.7 +/- 3.3 pg/mL, mean +/- 1 SE) were significantly lower than in the normoprolactinemic control group (48.7 +/- 8.4 pg/mL, P less than .01). A significant negative correlation (r = -.6157, P less than .01) between basal serum E2 levels and basal serum prolactin (hPRL) concentrations was found. Following hMG stimulation, the serum E2 increment (delta E2) from basal E2 levels in the control group (491 +/- 91 pg/mL) was significantly higher than the increment in the hyperprolactinemic group (182 +/- 48 pg/mL, P less than .01), and a significant negative correlation was observed between basal serum hPRL levels and the logarithm of delta E2 (r = -.4744, P less than .05). Our results suggest that chronic hyperprolactinemia induces ovarian refractoriness to exogenous gonadotropin stimulation and substantially reduces its steroidogenetic potential.

Hormonal profile during termination of midtrimester pregnancy by extraovular instillation of saline: plasma levels of prostaglandins, progesterone and human chorionic gonadotropin.

Midtrimester abortion was initiated for psychosocial reasons in 5 patients, and premature delivery in 2 patients with intrauterine fetal death using a new method for termination of pregnancy--the instillation of normal saline through the cervical canal into the extraovular space. Blood levels of 15-keto-13,14 dihydro-prostaglandin F2 alpha (PGF2 alpha-M), progesterone (P) and Human Chorionic Gonadotropin (HCG) were determined from the start of the procedure up to the expulsion of the fetus at frequent intervals in the peripheral circulation of these patients, by highly sensitive and specific RIA procedures. Following saline instillation and initiation of contractions, the concentration of PGF2 alpha-M increased significantly, reaching peak values either shortly before or at the time of delivery. This rise was associated with a significant decrease of P levels. Levels of HCG were variable. The possible significance of these results is discussed.