ABSTRACT
Thirty women with secondary amenorrhea and hyperprolactinemia were studied; galactorrhea was present in 25 of them, and 18 were infertile. Serum prolactin (PRL) levels were high in all cases, between 26 and 120 ng/ml. All women were treated with bromocriptine in increasing doses from 2.5 to 5.0 or 7.5 mg daily, according to the response obtained, for 4 months. In 27 patients a PRL determination was performed during treatment; values returned to normal (up to 20 ng/ml) in 23 women and remained high in 4. Galactorrhea disappeared in 21 of 25 women. Ovulatory menses were re-established in 17 patients (56.6%). Seven women became pregnant (38.8%), one of them after bromocriptine and clomiphene were given simultaneously in the same cycle. According to our results and a literature review the following conclusions may be drawn: (1) bromocriptine is a useful therapeutic tool for re-establishing menstruation and inducing ovulation in patients with the hyperprolactinemic-amenorrhea syndrome; (2) the association of bromocriptine and clomiphene could be the next step in the treatment of patients who fail to ovulate with bromocriptine alone.
Subject(s)
Amenorrhea/drug therapy , Bromocriptine/therapeutic use , Prolactin/blood , Adolescent , Adult , Clomiphene/therapeutic use , Female , Galactorrhea/drug therapy , Humans , Infertility, Female/drug therapy , Infertility, Female/etiology , PregnancyABSTRACT
In order to asses the effect of acute i.m. injection of clomiphene citrate (CC) on LH, FSH, and testosterone (T) secretion, five normal, fertile men received 5 mg of the drug dissolved in 2 ml 0.9% saline, while a further five were injected 10 mg of the same preparation. All tests were performed at 8 a.m. Blood samples were drawn at 0, 30, 60, 120 and 180 minutes of the injection. Serum LH, FSH, and T values were determined by the double antibody radioimmunoassay technique. A significant rise of the LH, FSH, and T levels was obtained in both groups. Peak LH values were obtained at 30 minutes (average), whereas FSH and T peaks occurred at 60 minutes. The 180-minute values were similar to basal. The results seem to indicate that intramsucularly administered CC could be useful, as a rapid test, in evaluating the function of the hypothalamic-pituitary-gonadal axis.
Subject(s)
Clomiphene , Follicle Stimulating Hormone/blood , Luteinizing Hormone/blood , Testosterone/blood , Adult , Clomiphene/administration & dosage , Humans , Hypothalamo-Hypophyseal System/physiology , Injections, Intramuscular , Male , Time FactorsABSTRACT
Thirthy one infertile women with different forms of anovulation were treated with LH-RH on various schemes of application: continuous intravenous (i.v.) infusion, intramuscular (i.m.) unique injection, continuous i.v. infusión plus i.m. unique injection, repeated i.v. injection, repeated i.m. injection and estrogens plus unique i.m. injection. On 46 cycles treated, ovulation was obtained in 18 (39.1%), 13 patients ovulated at least one cycle (41.8%) and six became pregnant (19.3%) three during the treatment and three during the first cycle post-treatment. The best results were obtained (63.2%) of ovulation) with the repeated i.v. injection scheme. Though the results obtained with LH-RH in relation to pregnancies, are lower than those obtained with other therapies of anovulation, the fact that we have been sucessful in cases on which other therapies of anovulation had been unsuccessful, the report up to now of only one case of mild ovary hyperestimulation, and the recent development of LH-RH analogs of more powerful and longer action, justifies the continuing of therpeutic assays with this hormone as to find the most effective scheme to induce ovulation.
