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Biomedical subjects

I D Cooke

Publications and source records attributed to I D Cooke.

At least 199 records · Page 11Linked to original sources
PubMed1987

Successful treatment of asymptomatic endometriosis: does it benefit infertile women?

The relation between asymptomatic endometriosis and infertility was investigated in a randomised double blind placebo controlled trial of the impact of treating the endometriosis with gestrinone. The 12 month cumulative conception rate in those patients treated with gestrinone was 25% (5/20) and in those given placebo 24% (4/17). These same patients were divided into those in whom no visible endometriosis was present at the second laparoscopy and those in whom residual disease was present and the 12 month cumulative conception rates were 25% (4/16) and 30% (6/20) respectively. None of these rates differed significantly, and they compared with a rate of 23% (6/26) in a control group of patients with unexplained infertility. Those patients in whom the disease was eliminated did not return to normal fertility, though all other causes of infertility were excluded. This study failed to show any impact of treatment or the absence or presence of asymptomatic endometriosis on future fertility compared with patients with unexplained infertility. The findings therefore question any causal role of the disease in infertility.

Clinical Trials as Topic↗
PubMed1987

Impact of gestrinone on the course of asymptomatic endometriosis.

A new drug, gestrinone, was subjected to the first double blind, randomised placebo controlled trial of any treatment of endometriosis. The disease deteriorated in eight (47%) of the 17 patients prescribed placebo (95% confidence limits 23% and 71%) compared with none of the 18 patients prescribed gestrinone (p = 0.002). There was a difference in elimination of the endometriosis in the gestrinone group compared with placebo but this was not statistically significant (p = 0.057). There was a significant difference in improvement of the disease in the gestrinone group compared with placebo (p = 0.004), confirming that gestrinone is an effective treatment of endometriosis. Endometriosis deteriorates in at least 23% of patients; as it is impossible to predict in whom this will happen, treatment appears to be warranted in all cases.

Adult↗
PubMed1986

Follicle growth patterns and endocrinological abnormalities in infertile women with minor degrees of endometriosis.

Eighteen patients whose only demonstrable cause of infertility was a minor degree of endometriosis and whose partners were normal, were investigated prospectively for one menstrual cycle using ultrasonography and endocrine profiles. Twelve cycles appeared to be normal. A luteinized unruptured follicle (LUF) occurred in two cycles and one patient had a follicular cyst. In a further two patients there was inadequate or abnormal folliculogenesis whilst in the last patient the follicle ruptured prematurely. This study describes the variety of endocrinological abnormalities found in women with mild endometriosis, and concludes that, in this series at least, there is a low frequency of LUF.

Endometriosis↗
PubMed1985

Norethisterone concentration in breast milk and infant and maternal plasma during ethynodiol diacetate administration.

Twelve women with established lactation of 4-8 weeks duration were given a low-dose progestogen-only contraceptive, ethynodiol diacetate 0.5 mg (Femulen) daily. On the seventh and eight day of the study, prior to the mother's taking the pill, a blood sample was taken from her and from the infant. Further blood samples were collected from the mother 4 and 12 hours later. Breast milk samples were collected at every feed on day 7 and day 8. Ethynodiol diacetate is rapidly metabolised in humans, changing into the metabolite norethisterone which is found in both blood and milk. Hence, norethisterone concentrations were estimated. On day 7 and day 8, four hours after ingestion of the pill, the median norethisterone maternal plasma concentration was 1.60 ng/ml and it fell to a median level of 0.30 ng/ml prior to the next dose of the pill. At this time the median infant concentration was 0.10 ng/ml but the maximum observed level was 0.50 ng/ml. In the breast milk the norethisterone concentration appears to peak at around 4-8 hours following the ingestion of the pill. The maximum observed concentration in breast milk was 0.84 ng/ml. The amount of norethisterone ingested by the infant averaged 0.02% (6.65 micrograms) of the dose of ethynodiol diacetate ingested by the mother. The maximum observed on any one day was 0.07% (27.52 micrograms). The above results indicate that the amount of progestogen ingested by the infant from its mother's milk is small and is unlikely to pose a risk to the infant.

Biotransformation↗
PubMed1985

Plasma gonadotrophin and ovarian steroid concentrations in women with menstrual cycles with a short luteal phase.

Daily plasma concentrations of FSH, LH, oestradiol-17 beta and progesterone were compared for 12 cycles with a short luteal phase and 19 cycles with a luteal phase of normal length (i.e. cycles in which the luteal phase lasted 12 or more days). FSH and LH concentrations were suppressed in short luteal-phase cycles in the early follicular phase and the length of the follicular phase was prolonged (median duration, 14.5 days, range 13-21 days: compared with 12 days, range 9-17, in control cycles; P less than 0.025). Preovulatory oestradiol-17 beta values and the mid-cycle concentrations of FSH and LH were similar in both groups. Plasma progesterone values in the luteal phase were similar in both groups over the 2nd to 5th days inclusive after the midcycle LH peak but declined in the short luteal phases thereafter. In short luteal-phase cycles, menstruation occurred in the presence of higher levels of oestradiol-17 beta and progesterone than in cycles of normal length and the rise of gonadotrophin in the late luteal phase of the cycle was delayed. These findings suggest that in cycles with a short luteal phase there is a lack of synchrony between the ovarian and menstrual events.

Estradiol↗
PubMed1984

Effect of bromocriptine on menstrual cycle length.

Forty-seven women with regular ovulatory menstrual cycles and normal plasma prolactin levels were treated with different doses of bromocriptine, and changes in follicular and luteal phase length determined by daily estimation of plasma gonadotrophin concentration. Follicular phase length was highly significantly reduced from a median duration of 12.7 days in the basal cycle to 11.7 days in the first treatment cycle, and to 10.7 days during the second treatment cycles. The length of the luteal phase was unaltered by treatment with bromocriptine. Reduction of follicular phase length was not influenced by the dose of bromocriptine used, and it is concluded that this effect is a consequence of the reduction of plasma prolactin concentration.

Adult↗
PubMed1984

The short luteal phase and infertility.

The distribution of the length of the luteal phase was investigated in 187 women with regular, apparently ovulatory menstrual cycles of whom 95 had unexplained infertility and the other 92 comprised a group of healthy volunteer subjects. If the short luteal phase is associated with infertility it might be expected to occur more frequently in women with unexplained infertility. A short luteal phase (defined as a luteal phase lasting less than or equal to 11 days) was found in 9% of the infertile group and in 8% of the normal group showing that these cycles do not occur more frequently in women with infertility.

Female↗
PubMed1983

Individual variation in gonadotrophin and steroid concentrations and in the lengths of the follicular and luteal phases in women with regular menstrual cycles.

Two cycles each with full endocrine profiles from 17 subjects were examined for within-subject (between cycles) and between-subject variability (one way analysis of variance) and for the degree of correlation between pairs of cycles (regression analysis, Pearson's correlation coefficient). LH concentrations were significantly correlated within subjects for the mid cycle (P less than 0.0001) and luteal phases (P less than 0.05) whereas FSH concentrations were significantly correlated throughout the cycle (P less than 0.01). Oestradiol, however, was only weakly correlated (P less than 0.05) and then only during mid-follicular and luteal phases. Progesterone concentrations were highly significantly correlated (P less than 0.0001) during the luteal phase as were both follicular (P less than 0.01) and luteal phase length (P less than 0.0001) and prolactin concentrations (P less than 0.001). All the reproductive hormones showed less variation within an individual than between individuals. This was particularly marked for FSH and prolactin (throughout the cycle) LH (during the mid-cycle surge) and progesterone concentrations (luteal phase). It is likely that the peripheral plasma levels of these hormones are characteristic of the individual and do accurately reflect the state of equilibrium existing between all of the physiological regulatory mechanisms. Further, the current practice of describing endocrine profiles in regularly cycling but infertile women in an attempt to understand possible causes of their infertility is, in the light of these findings, a physiologically justifiable procedure.

Adult↗
PubMed1983

Premenstrual levels of 17 beta oestradiol and progesterone in plasma in cycles of short and normal luteal phase length.

Premenstrual levels of 17 beta oestradiol and progesterone in plasma were compared between cycles of short or normal luteal phase length. Levels of progesterone and 17 beta oestradiol were higher premenstrually in cycles with short luteal phase lengths (11 or less days) that in cycles of normal luteal phase length (12 or more days). These findings suggest that reduction in the length of the luteal phase may arise because of a changed response of endometrium to withdrawal of 17 beta oestradiol and progesterone.

Adult↗
PubMed1982

Cytogenetic and histological studies in a series of subfertile males.

Cytogenetic and histological studies were carried out on a series of 68 men during investigations for subfertility. Somatic chromosome analysis identified 4 cases with abnormal karyotypes. Meiotic chromosome analysis identified 4 cases with abnormal meiosis. Analysis of cell stages of the spermatogenic cycle in cytogenetic preparations identified 12 cases with missing cell cycle stages. Histological analysis of tissue samples identified defects of the spermatogenic cycle in 23 cases. A kinetic model of spermatogenesis is used in order to relate the different types of abnormality to the spermatogenic cycle.

Adult↗