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Endometrial histology during intermittent intranasal luteinizing hormone-releasing hormone (LH-RH) agonist sequentially combined with an oral progestogen as an antiovulatory contraceptive approach.

Endometrial biopsies were performed in four groups of six or seven women treated for periods of 14 or 21 days with 200 micrograms twice daily or 400 micrograms once daily of intranasal Buserelin acetate. Five milligrams of medroxyprogesterone acetate (MPA) was taken orally twice daily on days 15 to 21. A medication-free week followed each treatment period. Between days 12 and 15 of the first treatment cycle, a proliferative endometrium was described in 16 out of 24 biopsies (66%). In 8 specimens (33%), early secretory changes were related to an early and/or short-lived rise in serum progesterone (P). At the end of the fourth treatment cycle, advanced maturation (days 23 to 28) was observed mainly in the 14-day schedules where serum estradiol (E2) was stimulated in or above the normal range of control cycles. Early to midluteal phase dating (days 16 to 22) was described mainly in the 21-day schedules. There was no P elevation in these groups. Five biopsies showing only proliferative tissue were associated with low levels of E2 mainly in the 400 micrograms/day group. The regimen capable of maintaining E2 in the low physiologic range (200 micrograms/12 hours X 21 days) was associated with incomplete secretory changes of the endometrium. A longer period of progestogen administration should produce a more complete maturation of the endometrium.

Adult↗

Circulating levels of placental protein 14 and progesterone following Mifepristone (RU38486) and Gemeprost for termination of first trimester pregnancy.

Ten patients underwent successful termination of first trimester pregnancies with RU38486 (Mifepristone, Roussel Laboratories Ltd., Broadwater Park, Uxbridge, Middlesex, United Kingdom) followed 2 days later by a prostaglandin (Gemeprost, May and Baker Ltd., Dagenham, Essex, United Kingdom) pessary. Four hours after administration of RU38486, the levels of progesterone (P) started to fall and continued to show a gradual decline until the abortion was completed, when a steep fall to follicular phase values was observed. Levels of placental protein 14 remained unaltered until 2 days after RU38486 administration, when levels were increased. The rise in placental protein 14 in association with falling P concentrations suggests that the decidual secretion of placental protein 14 might be independent of P. Fertil Steril 52:66, 1989.

Abortifacient Agents↗

The physiology of cervical ripening and cervical dilatation and the effect of abortifacient drugs.

The mechanical properties of the human uterine cervix are determined mainly by the connective tissue component, whereas it is doubtful whether the scanty smooth muscle component is of any physiological importance. Histological and biochemical analyses reveal a fibrous connective tissue similar to that found in skin and tendon. Degradation of the collagen and an increase in some special dermatan sulphate proteoglycans can at least partly explain the pregnancy-associated softening of this connective tissue. Relatively high oestrogen levels seem to be an absolute condition for the process, even when it is induced pharmacologically. Treatment with progesterone-receptor blockers, PGE2, PGF2 alpha or relaxin in pregnancy induce cervical softening as well as histological and biochemical changes which cannot be distinguished from the physiological cervical softening which takes place in late pregnancy. Prostaglandins and relaxin might interact and could include cytokines such as interleukin-1 during the process. The effect of cervical tents cannot be explained only by the radial pressures they exert. Most probably stimulation of local prostaglandin synthesis is also involved.

Abortifacient Agents↗

Estrogen concentrations in bovine and porcine tissues.

Using an estrogen antiserum that measures biologically active estrogen (estradiol-17beta + estrone), a series of studies have been completed to describe the normal plasma levels of estrogen in cows and sows during various stages of reproduction. The levels are lower in the nonpregnant cow (less than 25 pg/ml) than in most species. Only during late pregnancy are the levels easily assayed. The levels in the nonpregnant sow are 2-3 times greater than in the cow. In both species there is a preovulatory peak of estrogen that is responsible for estrus. Plasma estrogen concentrations were also determined after induction of multiple ovulations by exogenous gonadotropin (PMSG) in the cow and sow and after treatment of cows with either a progestin (MGA) or a prostaglandin (PGF2alpha). (These two drugs have been used to synchronize estrus in the cow.) Estrogen levels rise greatly after treatment with PMSG but show little effect from MGA or PGF2alpha. Data are also presented on the validation of an assay for E2beta and E1 in beef tissue. Less than 20 pg of E2beta and E1 was measured per gram bovine muscle tissue. Considerable effort must be expended to apply radioimmunoassay to the assay of estrogens in tissues.

Animals↗

Preliminary observations on steroid metabolism in isolated epithelum of guinea pig seminal vesicle.

The metabolism of nine radioactively labeled steroids in the epithelium of the seminal vesicle of the mature guinea pig has been studied. The rapid assimilation and metabolism of these steroids demostrate the very active biochemical nature of this tissue. Based on the use of several thin-layer chromatography systems and comparison with the locations of known standards, the following have been disclosed. Testosterone was rapidly converted to dihydrostestosterone and androstanediol. The latter was the major metablolite of dihydrotestosterone and of androsterone. Androstenedione was readily converted to androstanedione, testosterone, and dihydrostestosterone, although it formed little androstanediol. Dehydroepiandrosterone was converted to small amounts of androstenediol and androstanediol. Pregnenolone was rapidly converted to an unidentified highly polar compound only. Progesterone was converted to 5alpha-pregnane-3beta-ol-20-one and its 3alpha-isomer. Dehydroepiandrosterone and progesterone were also significantly converted to unidentified highly polar compounds. The major metabolites of 17-hydroxyprogesterone co-chromatographed with standard androstanediol, testosterone, and unidentified metabolite possessing intermediate chromatographic mobility. In addition, 17-hydroxyprogesterone was converted to small amounts of compounds possessing identical Rf values as standard androstenedione and dihydrostestosterone. The identification of the products of 17-hydroxyprogesterone metabolism and their physiologic significance must await critical evaluation. Because of its homogeneity, isolated epithelium of guinea pig seminal vesicle shows promise as a tissue preparation for use in future studies that might elucidate the role(s) of individual androgens in secretory tissues of the male accessory sex organs. Our demonstration of extensive steroid interconversions in this tissue is a logical prerequisite to such studies.

Androgens↗

Prolactin changes in maternal plasma following termination by vacuum curettage and the effect of bromocriptine treatment on these changes.

To study the prolactin secretion and its dependence on the sex steroid concentrations during pregnancy, we measured the circulating prolactin, oestradiol-17 beta, progesterone and testosterone levels following vacuum curettage for termination of early pregnancy in 10 normal women and in 10 other women whose prolactin levels had been lowered with bromocriptine treatment. In normal women, anaesthesia and vacuum curettage led to consistent and significant (p < 0.01) rises in prolactin levels between 0.5 to 5 hours after abortion. This increase was not seen in women treated with bromocriptine whose prolactin level of 8.6 +/- 1.4 ng/ml (mean +/- SE) before abortion was lower than that of 29.6 +/- 6.4 ng/ml found in normal women. The oestradiol and progesterone concentrations decreased rapidly but similarly in both groups of patients following the evacuation of the uterus, whereas the testosterone level did not change significantly. These results indicate: (i) vacuum curettage stimulates prolactin secretion, (ii) the prolactin-stimulating effect of stress appears to be stronger than the prolactin-suppressing effect of postabortal oestradiol and/or progesterone declines, and (iii) bromocriptine blocks the stress-induced prolactin rise.

Abortion, Legal↗