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The effect of the antiprogestin mifepristone (RU 486) on maturation and in-vitro fertilization of human oocytes.

The effect of RU 486 (mifepristone), a potent antiprogestin, on the in-vitro fertilization of human oocytes was investigated. In 40 normal volunteer women requesting laparoscopic sterilization, follicle aspiration for oocyte recovery was attempted 34 h after the injection of 5000 i.u. human chorionic gonadotrophin (hCG). Twenty women were allocated to receive 100 mg RU 486 orally 1 h before the hCG injection, the remaining 20 women acted as controls. There was no significant difference in the cleavage rate of the oocytes after fertilization in vitro between the two groups (56% and 66% respectively). Also, the morphological characteristics of the cleaving oocytes and the concentrations of oestradiol, progesterone and androstenedione in the follicular fluid of the leading follicle did not differ significantly between the two groups. Since RU 486 was detected in substantial amounts in the follicular fluid specimens, these results suggest that progesterone is not critical for the final stages of human oocyte maturation.

Estrenes↗

Sulprostone, a synthetic PGE2 analogue in first trimester abortion. Clinical efficacy and influence on serum progesterone of different single doses.

First trimester legal abortions were induced in 20 patients by i.m. injection of a single dose of 1,000, 1,200 or 1,500 micrograms of sulprostone. Complete expulsion of the conceptus within 24 h occurred in 16 of the women. There was a tendency to a higher rate of complete expulsion, as well as gastrointestinal side effects, at higher dosages. No association was found between the completeness of expulsion and the patients' serum progesterone levels before or after sulprostone injection.

Abortifacient Agents↗

Plasma progesterone levels following subdermal implantation of progesterone pellets in lactating women.

The magnitude and duration of elevated plasma progesterone levels resulting from subdermal implantation of progesterone pellets were investigated in full nursing women. This condition was chosen because it is associated with a low rate of ovulation and minimal endogenous progesterone production. In addition, treatment with progesterone pellets was intended to be a substitute for oral or parenteral administration of synthetic progestogens to nursing mothers. A control group of full nursing women receiving no hormones provided blood samples so that basal plasma progesterone levels from the second to the sixth post-partum month could be assessed. Progesterone pellets were implanted subdermally on day 30-35 after delivery. Insertion of 2, 4 or 6 pellets each containing 100 mg of progesterone caused an initial elevation of plasma progesterone to 5.9, 9.9 and 13.5 nmol/l, respectively. This initial elevation was followed by a gradual decline, so that basal levels were attained at 70, 100 and 150 days after insertion of 2, 4 or 6 pellets. Implantation of 6 progesterone pellets led to a significant decrease in the ovulation rate of nursing women. These results indicate that subdermal implantation of 6 progesterone pellets can provide biologically effective levels of the hormone for up to 5 months.

Adolescent↗

Urinary melatonin, LH, oestradiol, progesterone excretion during the menstrual cycle or in women taking oral contraceptives.

Nocturnal urinary excretion of melatonin, LH, progesterone and oestradiol was measured by radioimmunoassay in nine normal women during a complete cycle. In addition, these hormonal excretions were studied in two women taking an oral contraceptive. A high within-subject coefficient of variation was observed for melatonin excretion in the two groups. In the nine normal cycling women, melatonin excretion was not decreased at the time of ovulation, but was significantly increased during the luteal phase compared with that of the follicular phase (P less than 0.01). These data are consistent with a positive relationship between melatonin and progesterone during the luteal phase. In the two women under an oral contraceptive, melatonin excretion was found within the same range as for the other nine. The results are discussed in terms of pineal investigation in human.

Adult↗

Plasma luteinizing hormone and progesterone in the adult female pig during the oestrous cycles, late pregnancy and lactation, and after ovariectomy and pentobarbitone treatment.

In a series of experiments on female miniature pigs, the pattern of plasma LH and progesterone levels during the oestrous cycle, late pregnancy and lactation and after ovariectomy were characterized, and the effect of pentobarbitone treatment was tested. The preovulatory surge of LH occurred in seven out of eight animals between 00.00 and 12.0 h on day 0 of the oestrous cycle (day 1 of standing heat). Plasma progesterone strated to decline 8 days before oestrus and reached its lowest value 5 days before the preovulatory LH peak. Increases in progesteron concentration were already noticeable 48 h after the LH surge. During late pregnancy, parturition and lactation, plasma LH was low and showed only minor fluctuations, while plasma progesterone declined 4 to 5 days before parturition. Both hormones remained at low levels throughout lactation. Three weeks before parturition increases in LH were always followed by an increase in progesterone. This dependency was greatly diminished immediately before delivery. Four to 12 days after weaning the animals came into oestrus which was followed by an increase in LH and later an increase in progesterone concentrations. Ovariectomy during dioestrus resulted in a steady increase in plasma LH levels of 35-39 days. Ovariectomy caused abortion if performed on day 100 of pregnancy. It was followed by a rapid increase of plasma LH concentration. Normal parturition (around day 115) and lactation took place when animals were spayed on day 112 of pregnancy. In this case, plasma LH levels remained even lower than before ovariectomy as long as lactation was maintained. Immediately after weaning a rapid increase in the normal postovariectomy pattern of LH secretion was observed. Pentobarbitone anaesthesia (30-35 mg/kg body wt, initial dose), during pro-oestrusoestrus, for less than 5 h had no effect on the preovulatory LH increase. However, pentobarbitone anaesthesia for more than 6 h inhibitied the LH peak and ovulation if the animal was under deep anaesthesia before 24.00 h on the day before oestrus. Pentobarbitone treatment of ovariectomized pigs resulted in a clear decrease in LH levels 40 min after a single i.v. dose.

Animals↗

Cyclic fluctuation in noradrenaline transmitter of the monkey oviduct.

Cyclic variations in noradrenaline of the sympathetic nerves ("short adrenergic neurons") innervating the smooth musculature of the oviduct have been determined by fluorescence histochemistry and fluorometric measurements in monkeys (Macaca mulatta). During the secretory phase there is more than twice as much neuronal noradrenaline in the oviduct compared with the proliferative phase. This suggests, that the system of adrenergic nerves in the primate oviduct is involved in the motility changes associated with alterations in the level of endogenous estrogen and progesterone during the menstrual cycle.

Animals↗

Multicenter trial of a monophasic oral contraceptive containing ethinyl estradiol and desogestrel.

A clinical trial was conducted at 47 centers in 11 countries to assess the efficacy and acceptability of a monophasic oral contraceptive containing 30 micrograms ethinyl estradiol and 150 micrograms desogestrel. 1,613 women took part for a total of 23,258 cycles. One pregnancy occurred in a cycle where two consecutive tablets had been forgotten. Cycle control was excellent, with reported decreases in the duration and amount of withdrawal bleeding during consecutive treatment cycles and a low incidence of irregular bleeding. Blood pressure was not affected during 2 years of use. The incidence of minor side effects was already low in the first treatment cycle and decreased further in the subsequent cycles. The combination (Marvelon) was shown to be a very reliable and acceptable oral contraceptive.

Adult↗

Review of newer contraceptive agents.

Advances in contraceptive technology have made birth control more effective, convenient, and safe. We review the newer products and some under development, including the latest oral contraceptives, injectable progesterone, subdermal progestin implants, progesterone-releasing IUDs, emergency contraception, and male contraception.

Absorbable Implants↗

The medical management of menorrhagia.

Menorrhagia is a common problem which may result in chronic anaemia and cause considerable social embarrassment. Various medical treatments are available to reduce excessive blood loss, thus lessening the effects of this benign yet debilitating condition. In this article these drugs and their potential beneficial effects are reviewed.

Anti-Inflammatory Agents, Non-Steroidal↗

Does gender or the menstrual cycle affect colonic transit?

Controversy exists as to whether slowing of colonic transit occurs in the high progesterone luteal phase of the menstrual cycle. To clarify this issue, colonic transit studies using radiopaque markers were performed on 10 women in the follicular phase, 10 women in the luteal phase of the menstrual cycle, and five women on oral contraceptives, and the results were compared with transit times in 11 male controls. No significant differences in colonic transit were found between either phase of the menstrual cycle. Colonic transit in women was slower than in men, but this was not statistically significant. In the clinical setting, therefore, colonic transit studies can be performed throughout the menstrual cycle or when taking oral contraceptives. In addition, a single standard for normal values can be used for both men and women.

Adult↗

[Estrogen and progesterone receptors in the decidual tissue of women administered prostaglandins and experiencing spontaneous abortion].

A study was made of the content of estrogen and progesterone receptors (ER and PR, respectively) in the cytosol and nuclei of the decidual tissue of women in induced and spontaneous abortion at 7-12 week pregnancy. Abortion was done surgically (control group) and in preliminary cervical dilatation with the help of intravaginal suppositories with a synthetic prostaglandin analog of E1-16.16-dimethyltrans-delta 2-PGE1 (ONO-802) group or laminaria. The level of ER in the cytosol and nuclei of the decidual tissue of the control group was twice as low as that of PR, and the ER/PR ratio in cell fractions as well as in general cell receptors was 0.58 +/- 0.09, 0.42 +/- 0.07 and 0.56 +/- 0.07, respectively. The suppositories with ONO-802 caused a statistically significant decrease in the PR content in each of the cell fractions and cytoplasmic ER resulting in an increase in the ER/PR ratio to 0.87 +/- 0.06 (P less than 0.05) in the cytosol, 0.09 +/- 0.24 (P less than 0.05) in the nuclei, and 0.86 +/- 0.8 (P less than 0.05) in the total cell. A decrease in the PR level in both cell fractions and the ER level in the fraction of the nuclei with an acute increase in the content of cytoplasmic ER was marked in spontaneous abortion. The ER/PR ratio also rose to ER and was 1.98 +/- +/- 0.2 (P less than 0.001) in the cytosol and 1.02 +/- 0.16 (P less than 0.05) in the total cell. It was concluded that an absolute and/or relative decrease in the PR level plays an important role in mechanism of abortion.

Abortifacient Agents, Nonsteroidal↗