Induction of ovulation with purified urinary follicle-stimulating hormone in patients with polycystic ovarian syndrome.

Purified urinary follicle-stimulating hormone was used to induce ovulation in 18 patients with polycystic ovarian syndrome. Each ampule contained 75 IU of follicle-stimulating hormone and less than 0.11 IU of luteinizing hormone. Initial doses were 150 to 225 IU/day, later increased to a maximum of 375 IU, according to daily clinical controls and estradiol values. After 12 to 16 days, follicle-stimulating hormone treatment was suspended. Within 36 to 48 hours each patient received 5000 or 10,000 IU of human chorionic gonadotropin, rarely more. Ovulation occurred in 39 of 43 treatment cycles and hyperstimulation in nine. Seven patients had normal pregnancies with viable fetuses, including one pair of twins. Two had abortions. Analysis of the endocrine situation during therapy does not permit either pregnancy or hyperstimulation to be predicted. However, hyperstimulation is frequently accompanied by endogenous luteinizing hormone peaks and greater estradiol increases during the final phase of induction. Purified follicle-stimulating hormone has thus demonstrated its validity in inducing ovulation in patients with polycystic ovarian syndrome, apparently with equal or lower risks of hyperstimulation than with other gonadotropin preparations.

LH-HCG receptors: a study of the human corpus luteum of pregnancy.

Experiments on binding 125I-LH and 125I-HCG by the human luteal tissue of early pregnancy showed no certain presence of receptors. On the other hand, studies performed with cyclic luteal tissue demonstrated the presence of high specificity, significant affinity receptors. Possible interpretations with reference to the physiological increase in HCG and/or to the characteristics of extrauterine pregnancy are discussed.

Effect of drug-induced hyper- and hypoprolactinemia on human corpus luteum.

This study was performed on 8 patients with normal levels of PRL and ovulatory cycles. Three of these patients were treated with 5 mg/day Bromocriptine and three of them with 60 mg/day Metoclopramide from the beginning of the cycle in order to induce hypo- and hyperprolactinemia respectively. The other two women were left as control. Daily blood samples were collected for the determination of PRL, LH 17 beta-Estradiol and Progesterone. Patients were operated on between the 6th and the 8th day after the LH peak and corpora lutea enucleated and frozen for subsequent 125I-LH binding tests. An analysis of our data demonstrates that hypo- and hyper- prolactinemia induced with Bromocriptine and Metoclopramide respectively may cause luteal insufficiency, which is revealed by decreased blood levels of progesterone. Furthermore we have observed that specific binding for LH in human luteal tissue is always present (in normal, hypo- and hyperprolactinemic women) but is reduced in presence of very high or very low levels of PRL.

Effect of celioscopic ovarian resection in patients with polycystic ovaries.

Ovarian resection was performed by means of celioscopy in 12 patients with polycystic ovaries (PCO), who had not responded to clomiphene + HCG therapy. This therapy had induced ovulation in only 14% of 56 therapeutic cycles. Ovarian resection through celioscopy induced ovulation in 45% of cycles. Clomiphene + HCG therapy after resection in patients with no spontaneous ovulation induced ovulation in 44% of cycles. Seven pregnancies followed in 5 women, equal to 41% of patients. Hormonal patterns (FSH, LH, E2, progesterone, dehydroepiandrosterone sulfate, testosterone) before and after resection showed no significant variation. The authors emphasize other advantages of this technique, such as fewer surgical injuries than laparotomy, relative harmlessness of the treatment, the possibility of repeating it and of performing subsequent laparotomy.

Retrograde ejaculation: a more convenient method for artificial insemination.

A case of retrograde ejaculation not responding to medical treatment is described in which the problem of sterility was overcome by artificial insemination. The semen was collected from urine after coitus by previous alkalinization with 1.63 g NaHCO3 once daily. Pregnancy occurred at the 4th insemination during the 1st treatment cycle. This technique seems to be the most suitable for artificial insemination in cases of retrograde ejaculation.

Binding of HLH and HCG by human corpus luteum: an in vitro study.

The ability of human luteal tissue to bind HLH was studied. The tissue was obtained from patients subjected to gynecological operations intended to correct other than ovarian lesions. HLH iodinated with carrier-free 125I according to the Greenwood method was used. This material has a relatively low specific radioactivity (7-20 microCi/micrograms); therefore the biological characteristics of the hormone were expected to remain intact. The 90% binding point was estimated at 37 degrees C after 5 minutes. Inhibition experiments with HLH and HCG had a characteristic effect, even those with FSH and ovine prolactin indicated a significant interference with the bound hormone. Scatchard plots demonstrated large variability in the number of binding sites and relatively modest variability of constant (Kd).

Menometrorrhagia of the puberty: therapy with Clomiphene (Clomiphene and puberal menometrorrhagia).

The authors administrated the Clomiphene, in different doses, to 8 patients among 27 observed. These patients were checked for a long time by basal body temperature and in some cases, measuring total urinary estrogens and pregnandioluria. The therapy was administrated in 38 cicles of the 163 cicles observed. This drug got evident results on flux duration, less significant results on the cicle length. The Clomiphene produced ovulatory cicles in 58 per cent of the cases, against 7 per cent of spontaneous ovulatory cicles of the same patients. The drug effect is better in the cases with normo or moderate hypo or hyper estrogenism, not so good in the cases with a remarcable hypoestrogenism. The therapy with Clomiphene did not produce any inconvenient. The results got were put in comparison with those of the other drug (Ciclophenile) and the superiority of Clomiphene was confirmed.