Human leukocyte antigen in hydatidiform mole.

OBJECTIVE: To find any possible association between human leukocyte antigen (HLA) as a genetic marker and the development of hydatidiform mole (HM). METHOD: The lymphocyte microtoxicity technique was used to study the HLA antigens in 3 groups: 18 women with hydatidiform mole and their husbands (study group), 300 normal women (first control group), and 20 normal pregnant women and their husbands (second control group). RESULT: Hydatidiform mole is more frequent in women having HLA A1. The disease is more common in couples with partial compatibility of the B locus. CONCLUSION: HM occurs more frequently in women with certain HLA antigens and when the husband and wife have partial compatibility at the B locus.

Urinary hormonal profile during the first cycle of low-dose oral contraceptive pills in women.

Ovarian function was studied in ten normal fertile women before and during the first cycle on a low-dose micropill containing 30 mcg ethinyl estradiol and 150 mcg L-norgestrel. In a control cycle and the first treatment cycle, steroid metabolites estrone-3-glucuronide (E1-3G) and pregnanediol-3 alpha-glucuronide (Pd-3G) were measured in daily early morning urine (EMU) samples. Also, luteinizing hormone (LH) was estimated during the expected periovulatory period. During the first cycle of micropill intake, ovarian function was suppressed in all cases. This is evidenced by significantly lower E1-3G and Pd-3G and absent midcycle LH peak compared to control cycles. The pattern of steroid metabolites was almost flat with no peaks. It is concluded that there is no need to cover the first cycle of micropill intake with other contraceptive methods.

The effect of vaginal administration of low-dose oral contraceptive tablets on human ovulation.

The effect of vaginal administration of a low dose combined oral contraceptive pill containing 0.15 mg levonorgestrel and 0.03 mg ethinyl oestradiol was studied in twenty women for a total of 58 cycles. Ovulation was suppressed in all treatment cycles in women receiving two pills daily. Failure of suppression of ovulation occurred in four out of 26 treatment cycles in women receiving one pill daily. Only seven women complained of side effects; most of the side effects were mild and disappeared gradually within the first treatment cycle. Intermenstrual spotting was present in only one case receiving one pill daily. It is concluded that vaginal administration of low dose combined pills has a good ovulation suppression effect with minimal side effects and with good cycle control.

Vaginal administration of a combined oral contraceptive containing norethisterone acetate.

The effects of vaginal administration of an oral contraceptive pill containing 1 mg of norethisterone acetate and 0.05 mg of ethinyl oestradiol were studied in 20 subjects for a total of 57 cycles. The results show effective ovulation suppression in the two dose regimens used. The lower dose regimen was associated with fewer side effects and no breakthrough bleeding. No significant change was observed in the serum concentration of glucose, total proteins, albumin, cholesterol and HDL after several cycles of treatment in both dose regimens used. It is concluded that vaginal administration of this preparation of oral contraceptives is an effective alternative method of hormonal contraception.

Effect of aspirin on the luteal phase of human menstrual cycle.

The effect of aspirin (acetylsalicylic acid) on the luteal phase length and function was studied in ten normal cycling women. They received three grams daily for twenty days starting from the fifth day of the cycle. Urinary pregnanediol-3 alpha-glucuronide (Pg-diol- 3G ) and luteinising hormone (LH) were assayed in daily early morning urine samples together with daily vaginal smear for cytohormonal evaluation. The excretion profile of Pg-diol- 3G and LH of another group of ten normal women were taken as controls. Aspirin caused shortening of both cycle length and luteal phase duration. Available evidence suggests the presence of corpus luteum deficiency in the treated cycles.

Blood hormone levels in egyptian women on norethisterone oenanthate.

Ten Egyptian women who were using the injectable contraceptive norethisterone oenanthate (NET-OEN) for at least 6 months were monitored weekly for a period of 12 weeks by measuring 3 pituitary hormones (FSH, LH and prolactin) and 2 ovarian hormones (oestradiol 17-B and progesterone). It was concluded that NET-OEN is a strong ovulation inhibitor, at least after its use for 6 months. Prolactin levels were depressed and this is in contradiction with the findings in rats.

PIP: 10 Egyptian women who were using the injectable contraceptive norethisterone enanthate (NET-EN) for at least 6 months were monitored weekly for a period of 12 weeks by measuring 3 pituitary hormones (FSH, LH, prolactin) and 2 ovarian hormones (estradiol 17-B and progesterone). It was concluded that NET-EN is a strong ovulation inhibitor, at least after its use for 6 months. Prolactin levels were depressed and this is in contrast to the findings in rats.

Role of endogenous prostaglandins in pregnancy termination by 15-methyl PGF2 alpha.

Thirty pregnant women with foetal death in utero received 15-methyl PGF2 alpha to terminate their pregnancies. Two groups (15 cases each) matched for age, gravidity and age of pregnancy were studied. One group received indomethacin suppositories before and during the PG induction while the second group received the prostaglandin analogue therapy only. The group which received the prostaglandin biosynthesis inhibitor showed a longer induction-termination interval, more PG ampoules were used and the number of failed cases was higher. Thus, the Release of Endogenous prostaglandins seems to play a complementary role in the therapeutic termination of pregnancy.

Hormonal profile in IUD users.

PIP: This study evaluates the hormonal profile of women using 3 different types of IUDs to determine possible effects on ovarian function. 18 normally menstruating parous volunteers aged 20 to 25 years who were non-lactating and were at least 6 months postpartum and postabortive participated in the study. The women were divided into 3 groups, 6 women per group: 1) Lippes Loop C, 2) Cu 7 IUDs, and 3) Progestasert TM systems. Blood samples were collected 1) during 2 cycles in every case for hormonal assay, 2) on the 6th and 9th days of cycle (follicular phase), 3) daily from the 12th to the 16th (periovulatory period), 4) on the 20th and 24th days of the cycle (secretory phase), and 5) on the 1st day of the menstrual flow. Radioimmunoassay was used to determine the following hormones: estradiol 17-beta; serum progesterone; luteinizing hormone (LH); and follicle stimulating hormone (FSH). The length of the menstrual cycle was shortened after IUD insertion in cases fitted with Lippes Loop and Cu 7. This was due to the shortening of the luteal phase. The hormonal profile showed a lower midcycle peak of LH compared with control cycles. Serum estradiol analysis showed that estrogen secretion from the growing follicles was relatively lower after the IUD insertion. Serum progesterone levels were in ovulatory levels; however, serum progesterone levels in day +2 postovulatory were lower than the corresponding values in the control cycle. The hormonal profile in women using Lippes Loop or Cu 7 generally showed ovulation, confirming other studies. In those fitted with Progestasert system, the menstrual cycle and luteal phase lengths increased after IUD application by 1.8 and 1.0 days respectively. This is attributed to the effect of the locally released progesterone on the premenstrual endometrium. There were no marked changes in the levels of the hormones studied, suggesting the local action of the device and its lack of influence on the hypothalamic-hypophyseal-ovarian axis. This finding confirms those of other studies. Further studies should include planned laparoscopy around the periovulatory period together with ultrasonic monitoring of follicular development and corpus luteum formation.^ieng

Therapeutic value of indomethacin in threatened abortion.

One hundred cases of threatened abortion were randomly allocated to four lines of treatment namely, long acting progesterone, antispasmodic, indomethacin and placebo. The lowest success rate was encountered in the indomethacin treated group; symptoms of intolerance were common and three cases out of sixteen turned into missed abortion. Indomethacin does not offer any advantage over other lines of treatment in threatened abortion.

An evaluation of the luteinizing hormone releasing hormone (LH-RH) test in patients with secondary amenorrhoea.

An analysis of the gonadotrophin response to an intravenous injection of LH-RH (50 mug) has been undertaken in 41 patients with secondary amenorrhoea. Thirty-five of the patients were free of any recognizable pathology to account for their amenorrhoea and apparently had a dysfunction of the hypothalamic-pituitary axis. In these patients, the gonadotrophin response to LH-RH was highly variable. There was in general a correlation between baseline plasma LH or FSH levels and their respective increments. There was no correlation, however, between basal oestrogen levels and gonadotrophin increments except in the case of those patients whose basal levels of plasma FSH were higher than those of LH and in those patients whose body weight was less than the ideal for the population. It appears that the gonadotrophin response to a single injection of LH-RH in the majority of patients with secondary amenorrhoea of unknown origin is too variable to be of use either as a diagnostic or prognostic tool.