Induction of ovulation.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to E Radwanska.
Explore the source record for details and available documents.
Many women appear to experience menstrual disturbances after tubal sterilization. In this study the ovarian function in such women was investigated. Serial measurements of FSH, LH, estradiol and progesterone were performed throughout the study cycle in 23 previously sterilized patients, 14 with menstrual disturbances (group I--symptomatic) and 9 with normal cycles (group II--asymptomatic). A group of 28 parous women served as controls. Among 23 patients, luteal phase progesterone was elevated in 19, and in 4 it was undetectable (anovulatory). All four anovulatory patients belonged to group I. Anovulatory cycles were also characterized by tonic elevated LH levels. Mean midluteal progesterone values were lower in group I (8.5 ng/ml) than in group II (13.8 ng/ml) and in the controls (16.5 ng/ml). Mean midluteal progesterone was lower than 10 ng/ml in 78% of group I, 44% of group II and 15% of the control patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A midluteal (five to ten days before the onset of the next period) single serum progesterone measurement, used routinely to assess luteal function, revealed, in 48 infertile women, values lower than 10 to 15 ng/ml. Clomid alone or with human chorionic gonadotropin (HGC) was used in their treatment. Twenty-six (58%) women successfully conceived on Clomid or Clomid and HCG. Progesterone measurements before and during treatment showed that values of midluteal progesterone increased from a pretreatment mean of +/- SD of 9.0 +/- 5.9 to 27.3 +/- 10.3 ng/ml during conception cycles. The single progesterone measurement at midluteal phase is a useful guide in the management of ovulatory infertility.
Mid-luteal phase serum progesterone, cortisol, and corticosteroid-binding globulin concentrations were measured in 46 conception cycles and in 19 ovulatory, non-conception cycles in patients with spontaneous ovulation and following ovulation induction with clomiphene citrate (Clomid) or human menopausal gonadotropin. Significant elevations (P less than 0.05) of serum corticosteroid-binding globulin were noted in patients under therapy with Clomid. This effect was not secondary to elevated serum estrogen levels. This alteration in serum binding protein levels appears to be secondary to a direct effect of Clomid on hepatic synthesis and may have significance in relation to progesterone binding and metabolism during ovulation induction with Clomid.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Clomiphene citrate (Clomid), when given alone, is generally considered ineffective in inducing ovulation in women with hyperprolactinemia. This study reports the treatment of 29 infertile women with hyperprolactinemic amenorrhea. Twenty-one patients (eighteen of whom had previously had no ovulation response to Clomid alone) were treated with a combined regimen of Clomid (100 to 200 mg/day for 5 days) and two injections of 5000 IU of human chorionic gonadotropin (HCG), the first 8 to 10 days after Clomid withdrawal and a second injection 1 week later. Basal body temperature charts, conception, and/or plasma progesterone measurements showed that 19 patients ovulated (90%). There were 17 pregnancies in 12 of 21 patients (57% pregnancy rate) with 15 single live births and two abortions. When bromocriptine (Parlodel) became available, a total of 22 patients (including 14 patients previously treated with Clomid/HCG, six of them successfully) with amenorrhea associated with hyperprolactinemia were treated with this drug with dosages varying from 2.5 mg to 15 mg/day. Ovulation was confirmed in 20 patients (90%). There were 17 pregnancies in 15 patients (68% pregnancy rate) with 15 single live births and two first-trimester abortions. In all, 21 of 29 patients (73%) achieved one or more pregnancies resulting in live births with one or both of the above treatments. It is concluded that a combined Clomid/HCG regimen can often be used as an effective alternative to bromocriptine therapy in the treatment of infertility associated with hyperprolactinemic amenorrhea.
Forty women with normal menstrual cycles who had been sterilized by tubal ligation or electrocoagulation requested tubal reconstruction. As part of their preoperative evaluation, progesterone measurements were obtained in the midluteal phase (5-10 days before the next menstrual period). This group of women had a significantly lower (P less than 0.005) mean midluteal progesterone level (9.4 +/- 4.7 ng/ml) than a control group of 24 women with infertile male partners attending the same clinic (17.4 +/- 7.1 ng/ml). In 25 (62%) of the sterilized women, progesterone levels were less than 10 ng/ml, whereas in the control group such low values were found in only 4 (17%) of the women. Thus, reduced midluteal serum progesterone concentration appears more common among women with prior tubal ligation or electrocoagulation than among a control population of apparently normal women.
Explore the source record for details and available documents.
Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyperprolactinaemia and were treated with clomiphene citrate and human chorionic gonadotrophin (HCG), and plasma oestradiol, FSH and LH levels were measured. Although adequate pre-ovulatory oestradiol levels were present, the surge of LH was absent until the injection of HCG after which all patients ovulated. There were 12 pregnancies in 9 patients resulting in 10 full-term livebirths, one premature livebirth and one continuing pregnancy. The relevance of these findings to the possible role of prolactin in amenorrhoea is discussed.
Explore the source record for details and available documents.
Leukocyte alkaline phosphatase (LAP) and plasma estradiol (E2) were measured in 56 infertile women treated with clomiphene citrate and human chorionic gonadotropin (hCG) and in 21 infertile women treated with human menopausal gonadotropin (hMG) and hCG. Plasma LAP scores were found to correlate significantly with plasma E2 levels in both clomiphene- and hMG-stimulated patients, reflecting the depdence of LAP on the level of circulating plasma estrogens. However, the plasma LAP score failed to distinguish the difference between normal stimulated and hyperstimulated cycles following hMG administration. We conclude that plasma LAP measurements have little value in monitoring ovulation induction therapy.
Twenty-seven infertile patients with 'simple' amenorrhoea-oligomenorrhoea and eighteen with the polycystic ovary (PCO) syndrome were treated for induction of ovulation with clomiphene, human menopausal gonadotrophin and human chorionic gonadotrophin. The treatment was monitored by plasma oestradiol, testosterone, androstenedione and progesterone estimation. Women with PCO had significantly higher plasma androgen levels than women with 'simple' amenorrhoea (P less than 0--1 to P less than 0-001) both before treatment and during induction of ovulation. When ovulation was induced the pregnancy rate for women with the PCO syndrome with elevated androgens was 21% while for those with uncomplicated amenorrhoea it was 75%. It is concluded that high levels of circulating androgens might be a factor preventing conception in some patients in whom ovulation is apparently successfully induced.
Explore the source record for details and available documents.