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At least 793 records · Page 44Linked to original sources
PubMed1983

Elevated bioactive luteinizing hormone in women with the polycystic ovary syndrome.

Serum measurements of bioactive (bio) luteinizing hormone (LH), immunoreactive (i) LH, iLH/follicle-stimulating hormone (FSH) ratios, serum androgens and estradiol (E2) were determined in 20 women with the clinical diagnosis of the polycystic ovary syndrome (PCO), and compared with the levels of 10 women with chronic anovulation (CA) and 10 control subjects in the early follicular phase. Women with CA and control subjects had similar levels of E2, androgens, bioLH, iLH, and iLH/FSH ratios. Fourteen of 20 women with PCO had levels of iLH exceeding 3 standard deviations (SD) of the levels of control women (21 mIU/ml), and 13 of 20 had iLH/FSH ratios above 3.2 (3 SD of control levels). Nineteen of 20 women, however, had bioLH levels above 70 mIU/ml (3 SD of control levels). Mean levels for bioLH were 131 +/- 18 in PCO, 39 +/- 3 in control subjects, and 40 +/- 3 in women with CA. The ratio of bioLH/iLH was 3.5 +/- 0.4 in control subjects and 3.2 +/- 0.3 in women with CA but significantly elevated in PCO (4.6 +/- 0.4, P less than 0.05). There was, however, a significant positive correlation between bioLH and iLH values in PCO (r = 0.64, P less than 0.01). A significant correlation was found between bioLH and serum testosterone as well as between bioLH and serum dehydroepiandrosterone sulfate (DHEA-S) (P less than 0.05), although no correlation was found between iLH and serum DHEA-S. Weight and obesity also did not correlate with either iLH or bioLH in women with PCO and CA. These data suggest that bioLH may be an important hormonal marker in the clinical diagnosis of PCO.

Adolescent↗
PubMed1983

Acanthosis nigricans in a patient with streak gonads.

Acanthosis nigricans (ACN) is associated with ovarian disorders or abnormalities of carbohydrate metabolism. We saw a 21-year-old woman who had primary amenorrhea and ACN. Results of endocrine studies showed anovulation and low serum estradiol levels with increased gonadotropin concentrations. Laparoscopic examination disclosed bilateral streak gonads; the ovaries were completely replaced by fibrous tissue. Cultures of peripheral lymphocytes, skin fibroblasts, and the right and left ovaries demonstrated normal female karyotype 46XX in all mitoses studied. An autoimmune disorder was excluded by the absence of antithyroid and antiadrenal antibodies. Specific antibodies against ovarian proteins were also absent. A glucose tolerance test demonstrated fasting hyperinsulinemia and exaggerated serum insulin response to the glucose load. The observations in this patient exclude a primary pathogenic role for the ovary in the production of ACN; they also lend further support to a connection between the cutaneous disorder and insulin resistance.

Acanthosis Nigricans↗
PubMed1984

Adolescent menstrual irregularity.

Amenorrhea and oligomenorrhea in the adolescent female are often the result of anovulation due to an immature hypothalamic-pituitary-ovarian axis. A careful history, physical examination and selected laboratory tests can help to differentiate this type of transient menstrual irregularity from the large number of endocrine and anatomic abnormalities that also present in this age group.

Adolescent↗
PubMed1984

[Hypothalamic control of ovarian function and its disorders].

The biological clock of the female cycle is the ovary: the arise of estrogen primes the hypophysis for releasing hormones (GNRH) and cause the LH surge. Nevertheless, frequency and amplitude of GNRH are important points for the release of gonadotropic hormones and are involved in several pathophysiological situations: in corpus luteum insufficiency, in anovulation and in amenorrhoea.

Adolescent↗
PubMed1984

Hyperprolactinaemia and female infertility.

The clinical use of bromocriptine was investigated in 50 hyper- and 30 normoprolactinaemic women attending an infertility clinic and presenting with anovulatory cycles, oligomenorrhoea or amenorrhoea and the complaint that they had failed to become pregnant. The results confirmed that bromocriptine is effective in the treatment of hyperprolactinaemic states. Bromocriptine supresses prolactin secretion irrespective of the underlying pathologic process. Hyperprolactinaemia in humans is frequently associated with anovulation. Serum prolactin values showed no close correlation with the degree of menstrual abnormalities or galactorrhoea. Basal FSH and LH levels and the gonadotropin response to LH-RH were essentially normal in hyperprolactinaemia. Circulating E2 levels were largely subnormal suggesting an inhibitory effect of prolactin on ovarian E2 production. Prolactin levels over 100 ng/ml are suggestive of pituitary adenoma.

Adolescent↗
PubMed1983

Clomiphene citrate: nuances of clinical application.

The results of administration of clomiphene citrate to 507 patients in 578 pregnancy attempts were evaluated with respect to pregnancy rate, outcome, sex ratio, and life table analysis. The effect of dose and concomitant administration of human chorionic gonadotrophin (hCG) was also assessed. The overall pregnancy rate was 38% by individual patient and 43% by patient attempt. A pregnancy rate of 61% was recorded for couples in which anovulation was the only reproductive problem. The abortion rate was 23% in a population screened by serum beta subunit hCG determination within a week of the missed expected menses. Many patients had multiple adverse fertility factors and fully 29% had been treated unsuccessfully with clomiphene citrate prior to entry into the program. The discussion includes results from the literature over the past two decades.

Abortion, Spontaneous↗
PubMed1983

Infertility in women exposed to diethylstilbestrol in utero.

To evaluate the reproductive consequences of prenatal diethylstilbestrol (DES) exposure, 33 infertile couples were studied in whom the female had been exposed to DES in utero. Infertility was attributed to uterotubal junction obstruction in 3 couples, anovulation in 7, endometriosis in 11, cervical obstruction in 2, adnexal adhesions in 2, oligospermia in 1 and luteal insufficiency in 3; in 4 couples no cause of infertility could be identified. No unique intraabdominal abnormalities attributable to DES exposure were observed. Four tubal pregnancies occurred in women with grossly normal oviducts. Nine of 11 women who had previously undergone surgical manipulation of the cervix (cryosurgery, cautery or conization) developed cervical stenosis, and 8 of them were found to have endometriosis. Despite our not having an appropriate referral infertility population for comparison, these findings are consistent with the following hypotheses regarding women prenatally exposed to DES: (1) surgical manipulation of the cervix more frequently leads to cervical stenosis and ultimately pelvic endometriosis, (2) tubal pregnancies may occur by a mechanism unrelated to salpingitis, and (3) the spectrum of problems causing infertility is similar to that in the non-DES-exposed population.

Adult↗
PubMed1978

[Clinical experimental studies in the treatment of ovarian dysfunction with bromo-ergocryptin (pravidel) (author's transl)].

Among 62 patients with galactorrhoea a corpus luteum deficiency or anovulatory cycles were found in 35 cases by serum progesterone determination, endometrial biopsy or basal body temperature records. 27 patients had a hyperpro-lactenemic amenorrhoea-galactorrhoea syndrome. During treatment with 2.5-5 mg. of Pravidel daily the basal body temperature was recorded, the concentrations of serum FSH, LH, Prolactin and progesterone were determined by radioimmunoassay. Other possible reasons for infertility were investigated. 10 of the 19 patients with normal serum prolactins in the group with deficient corpus luteum or anovulation became pregnant after a short duration of treatment, whereas only 2 of the 16 patients with hyperprolactenemia became pregnant. Among 27 patients with secondary amenorrhoea 11 became pregnant. All these patients had increased serum prolactins. During treatment with Pravidel all patients showed a significant increase of FSH and LH concentrations and a decrease of the prolactin concentrations. The outcome of the pregnancy of the 58 patients who became pregnant during treatment with Pravidel was also reported. 14 of the 58 pregnancies occured following additional treatment with Dyneric or HMG/HCG. Up to now there were 18 term deliveries following uneventful pregnancies. There were no fetal anomalies. The abortion rate was not higher than in the general population. All results show that euprolactinemia is not alone characterized by normal prolactin concentration. The clinical signs and symptoms of galactorrhoea without increase of prolactin over 20 ng/ml. in conjunction with ovarian dysfunction must be classified as dysprolactinemia.

Amenorrhea↗
PubMed1982

[Fundamental studies on high risk factor of endometrial carcinoma functional and histological abnormalities of ovaries and uteri in experimental anovulatory rats (author's transl)].

Anovulatory sterility is considered as one of high-risk factors of endometrial adenocarcinoma. We produced an animal model of anovulation in Sprague-Dawley rats and compared the changes of reproductive organs, such as ovary and uterus, of androgen sterilized rats (ASR) with normal rats (NR). The results obtained were as follow: 1) Vaginal opening was observed at 45 days of age in all of NR, however it was observed in 63% of ASR at 300 days of age. 2) Infertility rate of ASR was 98%, and all of ASR revealed persistent estrus. 3) The ovarian and uterine weights of ASR were smaller than those of NR. 4) Numerous vesicular follicles and absence of corpora lutes were characteristics in the ovary of ASR. 5) Severe hyperplasia of the endometrium was recognized in 5 of 49 ASR, including 2 atypical hyperplasia. 6) Serum progesterone levels of ASR was significantly lower than that of NR. Therefore E/P ratio increased in ASR. 7) The uterine sensitivity of ASR to gonadectomy and estradiol administration was reduced. These results indicate that uterus of ASR is tonically stimulated by estrogen and that androgenization also causes proliferative alterations in uterine morphology.

Animals↗
PubMed1982

Sclerosing stromal tumor of the ovary.

This case study of a sclerosing stromal tumor of the ovary in a 29-year-old woman demonstrates that the tumor was a functioning lesion that secreted estradiol, progesterone, and testosterone. Clinically, there was anovulation with resultant infertility, which was resistant to therapy with clomiphene citrate. Removal of the tumor was followed by reversal of these abnormalities.

Adult↗
PubMed1981

Ovulatory dysfunction in patients with endometriosis.

The incidence of ovulatory dysfunction (anovulation, oligo-ovulation, and luteal phase defect) in 103 patients with endometriosis and infertility was found to be 27.2%. Ovulatory dysfunction was found to occur at a slightly higher age group than the patients with normal ovulatory pattern (p less than 0.02). Prior use of oral steroidal contraceptives does not increase the incidence of ovulatory dysfunction. In addition, there is no correlation between the duration of infertility, and te incidence of ovulatory dysfunction in this group of patients with endometriosis. This report suggests an association between endometriosis and ovulatory dysfunction in some patients, which adds to the etiology of their infertility. It is also suggested that the diagnosis of endometriosis should be suspected in cases of unexplained infertility, even if the pelvic examination does not have any positive objective findings.

Adolescent↗
PubMed1978

Study of the activity of antithrombin-III in latent cholestasis. (A clinico-pharmacological study of the relationship between antithrombin-III activity and steroid cholestasis).

The relationship between steroid cholestasis and antithrombin-III activity were examined in users of oral contraceptives (Infecundin or Bisecurin) and in patients receiving anabolic hormone therapy (Nerobol). The control group for the oral contraceptive users consisted of patients with spontaneous anovulation. The untreated control group consisted of healthy women in the reproductive age. The increase in antithrombin-III activity was found to be directly related to the decline of anion excretion. Latent cholestasis in itself is not associated with an increased antithrombin-III activity, nor is the activity of antithrombin-III affected by long-continued use of those anabolic steroids which produce no decrease in anion excretion.

Adult↗
PubMed1980

[Combined clomiphene-dexamethasone therapy in cases with resistance to clomiphene (author's transl)].

Combined clomiphene-dexamethasone treatment was applied to 13 patients with clomiphene-resistant anovulation which had been caused by androgenic hyperactivity of ovarian or adrenal origin. The women, following induced withdrawal bleeding, received 200 mg/die clomiphene over five days, from the fifth through the ninth days of their cycles, plus 2 mg/die dexamethasone over ten days, from the fifth to 14th days of cycle, after they had failed to conceive in response to clomiphene alone administered in rising doses up to 200 mg/die. Nine pregnancies were successfully induced by that treatment. Two of them ended in abortion and one in premature twin delivery. Combined clomiphene-dexamethasone treatment is recommended for clomiphene-resistant cases with ovarian or adrenal hyperandrogenism, particularly for patients with polycystic ovaries (Stein-Leventhal syndrome).

Adrenocortical Hyperfunction↗
PubMed1995

Alternatives in plasma gonadotropin and sex steroid levels in obese ovulatory and chronically anovulatory women.

OBJECTIVE: To evaluate the alterations in plasma gonadotropin and sex steroid levels in obesity. STUDY DESIGN: A study was conducted on 77 obese women, 30 with ovulatory menstrual cycles (group I) and 47 with chronic anovulation (group II), who were compared to 15 women of normal weight and with ovulatory cycles (group C). Obesity was determined on the basis of body mass index. Blood samples were obtained during the follicular phase of the cycle for measurement of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), estrone (E1) and estradiol (E2). RESULTS: Elevated LH, T, A and E1 levels were detected in group II when compared to group I and group C. A levels were also elevated (P < or = .05) in group I when compared to group C. There was no significant difference between the three groups in FSH, PRL, DHEAS or E2 levels. CONCLUSION: The elevated A levels in group I obese women show that even when ovulating, obese women are hyperandrogenic. This excessive A may activate the aromatizing system in adipose tissue, generating E1. When this occurs, the increase in E1 may trigger an increase in LH, with consequent ovarian hyperstimulation, leading to increased T and anovulatory cycles.

Adult↗
PubMed1994

Use of transvaginal ultrasound in diagnosing the etiology of menometrorrhagia.

Forty-five women with a chief complaint of abnormal vaginal bleeding from a few days' duration (spotting) to three to six months of bleeding (average, 4.5 months) were evaluated using a standard clinical approach followed by transvaginal ultrasound (US). Serum estradiol (E2), progesterone and/or endometrial biopsy was used to further clarify the etiology of the bleeding and confirm the clinical or ultrasound diagnosis. Anatomic findings were present in 31% of patients by US examination as compared to only 9% by clinical evaluation. An additional 9% of patients had polycystic ovary disease. Of the 16% of study patients on oral contraceptives with a clinical diagnosis of breakthrough bleeding, 33% had anatomic findings associated with the bleeding on US. The ultrasound image of the endometrium predicted the endometrial biopsy findings in all three patients with postmenopausal bleeding. In the remaining patients with a diagnosis of dysfunctional uterine bleeding (DUB) (a diagnosis usually made clinically by excluding other etiologies), US was helpful in excluding many patients with anatomic findings not detected by physical examination and in evaluating the endometrium, helping differentiate anovulatory from ovulatory DUB. US was helpful in predicting the hormonal and histologic endometrial status of the patients. Patients with more severe and prolonged DUB had low serum E2 with US findings of a single-line endometrium (consistent with low serum E2 and anovulation). US can be a valuable aid in evaluating women presenting with a complaint of abnormal vaginal bleeding by demonstrating anatomic findings frequently not discernible on pelvic examination, such as small cysts and leiomyomas and even endometrial carcinoma, and in evaluating the endometrium in terms of its thickness and, indirectly, the endometrial histology and the ovulatory and hormonal status of the patient. US can also be of value in confirming some diagnoses that are generally made clinically by exclusion, such as breakthrough bleeding from oral contraceptive use and DUB.

Adolescent↗
PubMed1976

Failure of positive feedback.

Failure of the hypothalamic-pituitary unit to release LH in response to oestrogen may be encountered with or without associated disturbance of negative feedback. Such positive feedback failures can be detected with the aid of an oestrogen provocation test. Application of this test in women presenting with anovulatory cycles permits one to distinguish between an hypothalamic or ovarian cause (e.g. deficient follicular development) for anovulation. In women with infrequent or absent menstruation and infertility an oestrogen provocation test, combined with basal gonadotrophin and prolactin measurement and pituitary response to LH-RH, may prove to be useful in selecting the appropriate treatment for induction of ovulation.

Adolescent↗
PubMed1994

Exogenous gonadotropin therapy in World Health Organization groups I and II ovulatory disorders.

OBJECTIVE: To analyze cumulative conception rates and the prognostic factors influencing them during exogenous human menopausal gonadotropin (hMG) therapy for World Health Organization (WHO) group I or II ovulatory disorders. METHODS: A retrospective review was conducted of 468 treatment cycles in 146 women with ovulatory disorders refractory to conventional therapy. Cumulative conception rates were calculated, and the effects of diagnostic group, age, gravidity, and duration of infertility were examined using the Cox proportional hazards model. RESULTS: The cumulative proportion pregnant following six hMG cycles in WHO group I (0.89) was significantly greater than in the hyperandrogenic subgroup of WHO group II (0.30) (95% confidence interval [CI] 0.2-0.7, P = .006) or the luteal phase defect subgroup (0.35) (95% CI 0.07-0.6, P = .02). Conception rates in WHO group I did not differ significantly from those in the normoandrogenic oligo-ovulatory subgroup of WHO group II (0.63) (95% CI 0.3-1.3, P = .6). Conception rates were not influenced by duration of infertility or primary versus secondary infertility. Women 35 years or older had significantly lower conception rates than those aged 27 years or less (P = .04, hazard ratio 0.3, 95% CI 0.1-0.8). CONCLUSIONS: Cumulative conception rates following exogenous gonadotropin therapy for women with refractory ovulatory disorders were both diagnosis- and age-dependent. Treatment with hMG approximated or surpassed normal fertility rates in women with WHO group I and normoandrogenic WHO group II oligo-ovulation, but was significantly less successful at correcting the underlying defect in women with hyperandrogenic anovulation and luteal phase defects.

Adult↗
PubMed1993

Serum LH levels in the differential diagnosis of hirsute anovulatory women.

Polycystic ovarian syndrome (PCO) occurs frequently in hirsute patients. A dissociated explosive response of LH to LHRH administration has been associated with the diagnosis of PCO. Twenty-four of 58 women seen because of hirsutism were found to have ovarian dysfunction based on clinical signs such as anovulation and irregular menstrual cycles. Plasma androgen levels were elevated in the patient group. The LHRH test (200 micrograms, iv) was applied to the 24 patients and compared with 13 normal ovulatory controls. Serum FSH levels before and after the LHRH test were normal in all patients. Two patterns of LH response to LHRH stimulation were observed: an explosive response in 17 patients (delta LH: 39.4 +/- 21.8 IU/l, control group: 7.35 +/- 4.4 IU/l, P < 0.01) and a normal response in 7 patients (delta LH: 7.53 +/- 2.41 IU/l). There was a significant correlation (r = 0.63, P < 0.05) between basal LH levels and LH response to LHRH. Sensitivity and specificity calculated for basal LH levels higher than 6.0 IU/l, considering the LHRH test as reference, were 58% and 85%, respectively. The positive predictive value measuring the possibility of LH higher than 6.0 IU/l to be from a patient with PCO (explosive response to LHRH) was 92%. These data suggest that, in hirsute anovulatory patients, basal LH levels may be a good predictor in the diagnosis of polycystic ovarian syndrome.

Adolescent↗