Elevated LH concentrations are frequently encountered in patients with polycystic ovary syndrome (PCOS) and increased LH (either endogenous or superimposed through the use of HMG) may have detrimental effects on reproductive function. In spite of this, FSH-only products and HMG have been used indiscriminately for ovulation induction - on the basis that the administration of HMG to patients with PCOS, who are not receiving GnRH agonists, does not result in significant increases in serum LH concentrations as judged by daily single blood samples. However, both endogenous and exogenous LH have a relatively short terminal half-life and studies have reported normal serum LH, but abnormal urinary LH and emphasized that early morning urinary measurements are more informative than those in serum because they reflect nocturnal LH secretion. Therefore, the present study was undertaken to perform a pharmacokinetic and endocrine comparison of recombinant human FSH and HMG in PCOS patients including LH measurements in the urine. Five PCOS patients receiving s.c. recombinant human FSH (rhFSH) and five PCOS patients receiving i.m. HMG for ovulation induction according to a chronic low-dose step-up regimen underwent blood and urine sampling at the following study points: Point 0 was the day of HCG injection; Points 1 to 5 corresponded to days HCG -1 to -2; -3 to -4; -5 to -6; -7 to -8; and -9 to -10; respectively. Serum hormone measurements included oestradiol, FSH, LH, progesterone, inhibin A, androstenedione, testosterone, and free testosterone index. FSH and LH were also measured daily in 8-h urine samples reflecting overnight renal urine secretion. Hormone concentrations calculated as the area under the curve showed that both FSH and LH concentrations in urine were significantly higher in HMG group than in group rhFSH. It is concluded that both LH and FSH concentrations significantly accumulate in the urine of PCOS patients receiving HMG for ovulation induction in a chronic low-dose protocol as compared with rhFSH treatment.

Adult↗

PubMedDate not supplied

Shared HLA antigens between parents and recurrent spontaneous abortion.

Ten couples with a history of at least three (mean 3.8) consecutive spontaneous abortions of unknown etiology and 57 normal fertile couples (means 2.6 children) were tested for HLA antigens. The frequencies of shared HLA-A, -B and -DR antigens among members of the couples were similar in both groups. Our results, as well as analysis of the data in the literature, contradict HLA antigens sharing between parents as a determinant of recurrent spontaneous abortion.

Abortion, Habitual↗

PubMedDate not supplied

Further data on the usefulness of combined high-dose estrogen and human menopausal gonadotropins for cervical factor.

We report here our series of seven patients treated for cervical infertility with combined high-dose conjugated estrogen and human menopausal gonadotropins. Nine of 11 treatment cycles (81.8%) were ovulatory, and 57.1% of treated patients conceived (three single pregnancies and one set of quadruplets). Criteria for selection of patients for this combined therapy are established.

Adult↗

PubMedDate not supplied

Luteal phase deficiency: an inadequate endometrial response to normal hormone stimulation.

Two hundred seventy-four infertile patients and 43 women with two or more previous first-trimester abortions underwent a luteal function evaluation by basal body temperature, plasma progesterone, estradiol and prolactin determination, and endometrial biopsy (repeated in a later cycle when the first was defective). An endometrial luteal phase deficiency was detected in 37 (13.5%) of the infertility cases and in 14 (32.5%) of the patients with recurrent miscarriage. However, the endometrial defect was associated with normal hormonal levels in the great majority of patients (86.3%).

Abortion, Habitual↗