Bromocryptin and epimestrol in MAP-negative secondary amenorrheas.

18 patients, between 18 and 24 years of age, affected by normoprolactinemic secondary amenorrhea and still MAP-negative after three successive Epimestrol cycles underwent five cycles of a combined treatment (Bromocryptin and Epimestrol). Before and after the first cycle of combined treatment, in all patients FSH, LH, E2 and PRL were measured. Progesterone was evaluated three days after the thermic rise. The basal temperature was measured daily. In all the examined patients the combined treatment produced the appearance of the menstrual flow after the third therapeutical cycle. In 13 out of the 18 examined patients ovulation was observed. The hormonal dosage highlighted a clear increase in Gonadotropins and Estradiol levels.

Treatment of chronic anovulation and corpus luteum deficiency with epimestrol.

Ten patients presenting with anovulatory syndrome (AS, 4 patients), inadequate luteal phase (ILP, 3 patients) and short luteal phase (SLP, 3 patients) were treated with epimestrol for 29 cycles in total. The initial treatment was always 10 mg/day for 10 days followed by a modification of the daily dose and/or length of treatment needed. Ovulation was induced in all 4 AS patients with an adequate luteal phase (ALP) in 3 of them. In all other patients (with ILP and SLP) an ALP was induced; 2 of them became pregnant. No side-effects were reported.

[Epimestrol in childless marriages (author's transl)]. / Epimestrol bei kinderloser Ehe.

In a gynaecological practice 49 patients were treated for primary or secondary infertility with epimestrol between January 1977 and June 1979. The selected group all had normogonadotropic, normoprolactinaemic anovulatory cycles (group II of the WHO scientific group 1976). Therapeutic measures extended over a total of 176 cycles in which 5 mg epimestrol (1 tablet Stimovul) were prescribed from the 5th to the 14th day. This procedure led to at least one ovulation in 86% of the cases and to pregnancy in 30 of the women. 23 pregnancies were without major complications. The abortion rate was 23%. Side effects of epimestrol treatment were only seen in occasional cases and only at the beginning of treatment.

[Treatment of infertile women with epimestrol (author's transl)]. / Behandlung steriler Frauen mit Epimestrol. Erfahrungsbericht über 143 Patientinnen mit 30 Graviditäten

155 patients have been treated with epimestrol during 593 menstrual cycles in a daily dosage of 5, 10 or 2.5 mg from the 1st to the 10th or from the 5th to the 14th day of the cycle. 143 patients with secondary amenorrhoea, anovulatory cycles, ovulatory oligomenorrhoea, corpus luteum insufficiency, and normal cycles received epimestrol after an average period of 2.4 years of involuntary infertility. The pregnancy rate was 21% (n = 30), the spontaneous abortion rate 13% (n = 4). Twelve further patients not seeking pregnancy were treated with epimestrol because of secondary amenorrhoea and (or) anovulatory bleeding. The results were as follows: 1) In eugonadotropic secondary amenorrhoea 8 out of 12 patients ovulated, 5 out of 10 patients wanting children became pregnant. No patient with hypogonadotropism ovulated. 2) Out of 25 patients with anovulatory cycles or bleeding 13 ovulated and 4 became pregnant. 3) 17 out of 68 oligomenorrhoeic patients became pregnant. 4) In 12 out of 24 patients with corpus luteum insufficiency the hyperthermic phase improved and four patients became pregnant. 5) In 12 patients without anomalous cycles these remained unchanged and there were no pregnancies. 6) No side effects could be observed.

PIP: 155 women (593 cycles) were treated for sterility with daily doses of 5, 10, or 2.5 mg of epimestrol, from the 1st to the 10th or from the 5th to the 14th day of the cycle. 143 of these patients suffered from secondary amenorrhea, anovulatory cycles, ovulatory oligomenorrhea, corpus luteal insufficiency, and even normal cycles, which resulted in an average of 2.4 years of involuntary sterility. The pregnancy rate was 21% (n = 30) and the rate of spontaneous abortion 13% (n = 4). 12 other women were treated with epimestrol because of secondary amenorrhea or anovulatory bleeding. In those patients with eugonadotropic secondary amenorrhea, 8 of 12 ovulated and 5 of 10 desiring children became pregnant. No patients with hypogonadotropism ovulated. Of 25 patients with anovulatory cycles or bleeding, 13 ovulated and 4 became pregnant. Of those with oligomenorrhea, 17 out of 68 became pregnant. 12 out of 24 patients with corpus luteal insufficiency showed in improvement in the hyperthermic phase and 4 became pregnant. 12 patients with normal cycles showed no change and did not become pregnant. No side effects were experienced.

[Induction of ovulation with Epimestrol (author's transl)]. / Epimestrol--eine ovulationsauslösende Substanz

Epimestrol 5 mg. daily for 10 days was administered in 119 treatment cycles to 21 women with normal gonadotropins and 33 ovulations were induced. Of the 21 patients, 7 had secondary amenorrhea, 10 had anovulatory oligomenorrhea and 4 had ovulatory oligomenorrhea. 17 patients desired pregnancies and 6 became pregnant. There was 1 pregnancy among 5 women with secondary amenorrhea. There were 3 pregnancies among 9 patients with anovulatory oligomenorrhea and 2 pregnancies in 3 patients with ovulatory oligomenorrhea. The pregnancy rate was 35%. Side effects were not observed.

Assessment of the therapeutic effect of epimestrol and epimestrol associated with clomiphene in female sterility.

In 24 women with disturbances of ovulation treated for sterility with Epimestrol, ovulation was achieved in 3 patients but none of these became pregnant after therapy. Since it has been suggested that the association of Clomiphene with a weak estrogen might improve the pregnancy rate, we decided to administer Clomiphene associated with Epimestrol. Using this combined therapy in 58 patients, 32 out of the 58 women ovulated and 17 conceived. The overall rate of pregnancy using the combined therapy was no better than that obtained when Clomiphene alone is administered. From this study it is concluded that: (1) Epimestrol is not an effective method for the induction of ovulation, and (2) addition of Epimestrol to Clomiphene is of no clinical benefit.