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Biomedical subjects

G I Swyer

Publications and source records attributed to G I Swyer.

At least 19 recordsLinked to original sources
PubMed1982

Potency of progestogens in oral contraceptives--further delay of menses data.

The original Delay of Menses Test was designed to provide a guide to suitable starting dosages in formulating new contraceptives. The ability of progestogens to maintain uterine hemostasis was measured and a potency relationship among progestogens was predicated. No delay of menses data previously reported have related to tests of progestogens combined with the same dose of estrogen as used in current oral contraceptives. The Delay of Menses Test was repeated using a standardized dose of ethinyl estradiol and doses of four progestogens each found in combination with EE as marketed oral contraceptives. New and more meaningful relative potencies were derived.

Adult↗
PubMed1979

Addison's disease.

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Addison Disease↗
PubMed1979

Induction of ovulation in women with hyperprolactinemic amenorrhea using clomiphene and human chorionic gonadotropin of bromocriptine.

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.

Adult↗
PubMed1979

Testosterone concentration in different functional compartments of the male reproductive tract.

The concentration of testosterone in testicular tissue (TT), spermatic vein blood (SVB), cubital blood (CB), and seminal fluid (SF) was estimated using a radioimmunoassay technique in a total of 50 normospermic, oligozoospermic, and azoospermic men. Testosterone was also determined in cauda epididymis-vas deferens ductus wash fluid (WF) in 6 normospermic men. In 2 oligozoospermic men the testosterone concentration in TT was 556 and 725 ng/g tissue, respectively. In 9 normospermic men the mean SVB testosterone concentration was 473 ng/ml. CB and SF concentrations of this steroid were 6.8 and 0.4 ng/ml in normospermic, 6.4 and 0.5 ng/ml in oligozoospermic, and 4.9 and 0.4 ng/ml in azoospermic men, respectively; the difference among the three groups was not significant. The SVB:CB and SVB:SF ratios in normospermic men were 71 and 1549, respectively, while the CB:SF ratio was 18 in normospermic, 18 in oligozoospermic, and 16.6 in azoospermic men. Testosterone could not be detected in individual specimens of WF, but after pooling of samples a concentration of 0.08 ng/ml WF was estimated. These results demonstrate the relative concentrations of testosterone in the different functional compartments of the reproductive tract in man and facilitate a better understanding of its function.

Adult↗
PubMed1978

Pituitary-testicular interrelationships in mumps orchitis and other viral infections.

Leydig-cell function was assessed in 27 men with acute mumps orchitis by measuring plasma testosterone concentrations before and after the administration of human chorionic gonadotrophin (HCG). The test was also performed on groups of patients with other febrile viral infections and mumps without orchitis and on healthy euspermic men. The concentrations both before and after HCG were significantly lower in patients in the acute phase of mumps-but not in those with other viral infections and mumps without orchitis-than in the healthy men. Basal concentrations of follicle-stimulating hormone (FSH) and luteinising hormone (LH) were significantly increased in patients with acute mumps orchitis, while an exaggerated response to LH-releasing hormone was noted in four patients after the acute phase of the disease. Raised plasma LH concentrations were also found in several patients with viral infections, including mumps without orchitis. There appeared to be no particular merit of any of the treatments used (aspirin, prednisolone, and cold baths). In patients reevaluated three to five and 10 to 12 months after the acute phase of their disease the basal testosterone concentrations were similar to those of the healthy men, but several of the patients showed a severely impaired response to HCG. Mean basal FSH and LH concentrations were significantly increased 10 to 12 months after the acute phase, while the mean LH concentration was also raised at three to five months.It is concluded that mumps orchitis impairs Leydigcell function during the acute phase of the disease but may also have a more permanent damaging effect, similar to that found in the germinal epithelium.

Acute Disease↗
PubMed1978

Prolactin and luteal insufficiency.

The relationship between mid-luteal plasma levels of progesterone and prolactin was studied in 75 women with regular menstrual cycles. Eighteen women had normal prolactin (mean 260 +/- 51.7 mU/l) and normal progesterone levels (mean 67 +/- 21.3 nmol/l). Thirty-nine women had elevated prolactin levels (mean 850 +/- 503 mU/l): progesterone levels were normal in all cases (mean 61 +/- 22.3 nmol/l). Eighteen women had evidence of luteal deficiency (mean progesterone 15.3 +/- 7.7 nmol/l); prolactin levels were normal in all cases (mean 243 +/- 106 mU/l). There was no correlation between plasma prolactin and progesterone levels.

Adult↗
PubMed1978

The treatment of mild adrenal hyperplasia and associated infertility with prednisone.

Thirty patients with mild post-pubertal adrenal hyperplasia, characterized by raised urinary 17-oxosteroid levels and variable combinations of irregular menses, hirsuties, infertility, and spontaneous abortion, were treated with 2.5 to 10 mg of prednisone per day and all conceived (55 pregnancies). With this treatment, regular, ovulatory cycles occurred immediately in 25 patients, and after two to six months, in the rest. Treatment reduced raised 17-oxosteroid levels to normal and brought about some improvement in hirsuties and acne. Forty-seven pregnancies ended in the birth of liveborn infants; one of these died of prematurity and another had congenital emphysema. One pregnancy was terminated, two were of unknown outcome and five (9.4%) ended in abortion. Before treatment, 20 out of 22 pregnancies (91%) had ended in abortion.

17-Ketosteroids↗
PubMed1978

Induction of ovulation with clomiphene and human chorionic gonadotrophin in women with hyperprolactinaemic amenorrhoea.

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.

Adult↗
PubMed1977

A comparison of leukocyte alkaline phosphatase and plasma estradiol measurements in the monitoring of clomiphene and gonadotropin therapy.

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.

Adult↗
PubMed1977

Hypogonadal men treated with oral testosterone undecanoate.

Three hypogonadal male subjects with very low plasma testosterone levels were given testosterone undecanoate orally (120 mg daily for 3 weeks) as a replacement therapy. Normal adult male testosterone plasma values were rapidly reached and attained throughout the therapy. Similar elevations of plasma androstenedione were noted. A reduction in sex hormone binding globulin following the therapy was observed. Satisfactory clinical responses were reported by the patients. We thank Organon Laboratories Ltd. for supplying TU and financial help with this project.

Administration, Oral↗
PubMed1976

Plasma testosterone and androstenedione levels during monitored induction of ovulation in infertile women with 'simple' amenorrhoea and with the polycystic ovary syndrome.

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.

Adolescent↗
PubMed1976

Determinantion of testosterone concentration in semen of men with normal or subnormal sperm counts and after vasectomy.

Semen from 58 male subjects, aged 22 to 50, was assayed on an individual basis to determine whether T was present in it. Of the subjects examined 23 were normospermic, 14 oligospermic and 9 azoospermic; 12 men had undergone vasectomy were also included in the study. In 39 of the subjects plasma testosterone was estimated. A competitive protein binding technique was employed for T assays while dried extracts of semen were examined by combined gas-chromatography-mass spectrometry and mass fragmentography. Measurable amounts of T were detected in all seminal specimens assayed. This was confirmed by gas chromatography-mass spectrometry which showed a spectrum suggestive of T. The ratio of unconjugated to conjugated steroid in semen was found to be approximately 1:10. Levels of unconjgated T were similar to those found in plasma of normally menstruating women. The mean seminal concentration of unconjugated T (+/-SD) in the specimens assayed was 0.71 ng/ml+/-0.08 for the normospermic, 0.79+/-0.14 for the ezoospermic, 0.69+/-0.09 for the oligospermic, but only 0.38+/-0.04 for the vasectomized subjects. Plasma levels for this androgen were within the range found in normal men of comparable age. Significant correlation between plasma and seminal T concentration could not be demonstrated and there was no correlation between either of the above parameters and the seminal volume, the number, abnormal form percentage and the motility of spermatozooa in the normo--or oligospermic group. However, when the two groups were pooled into one, significant correlations were found between plasma, (but not seminal T concentration) and the seminal characters examined, perhaps suggesting the number of specimens from the groups should be increased to obtain valid data. Administration of human chorionic gonadotropin produced a marked plasma response as well as a rise of seminal T levels in 3 normospermic subjects whereas cyproterone acetate caused reduction of plasm T levels but had no consistent effect on the seminal concentration of ts steroid although the sensitivity of the seminal method may not have detected smaller changes at this level.

Adult↗
PubMed1975

Plasma oestradiol and progesterone estimation for the monitoring of induction of ovulation with clomiphene and chorionic gonadotrophin.

Two hundred and thirty-five courses of treatment with clomiphene and human chorionic gonadotrophin (HCG) were administered for the induction of ovulation in 75 infertile women (three with primary amenorrhoea, 45 with secondary amenorrhoea and 27 with oligomenorrhoea) of whom 61 had previously been unsuccessfully treated with clomiphene alone. The treatment was monitored by plasma oestradiol estimations on day 15 and day 22 in 103 cycles and by plasma progesterone estimations on day 22 in all 235 cycles. Injections of HCG were given on day 15 and 22. Twenty patients failed to respond to treatment (43 courses). The remaining 55 patients showed no response in 32 courses, deficient responses in 55 cycles and adequate responses in 105 cycles (plasma progesterone level exceeding 10 ng per ml on day 22). The mean values (+/- SD) of plasma oestradiol on day 15, reflecting follicular development, were: 73 +/- 30 pg per ml for cycles with no response; 255 +/- 182 for deficient cycles and 366 +/- 226 pg per ml for adequate cycles. There was a positive correlation (r = 0-57) between day 15 plasma oestradiol and day 22 plasma progesterone values. Increased clomiphene dosage resulted in higher plasma oestradiol and progesterone levels. Thirty-nine pregnancies occurred in 34 out of 55 patients capable of response (62 per cent). The plasma progesterone levels during conception cycles were higher than those in non-conception cycles in the same patients. Monitoring of induction of ovulation by plasma hormone estimations allows detection and correction of inadequate response.

Amenorrhea↗