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Assessment of ovarian function in perimenopausal women after stopping oral contraceptives.

Ovarian function was assessed by measuring plasma gonadotrophins, urinary oestrogen and urinary pregnanediol levels, every week for four weeks, in 34 women, aged 45 to 57 years, after withdrawal of oral contraceptive therapy. A rise in urinary pregnanediol excretion occurred in 14 patients suggesting that ovulation had occurred and that these patients were "premenopausal". Elevated serum gonadotrophin values and persistently low urinary oestrogen and pregnanediol excretion occurred in 13 patients suggesting ovarian failure or a "postmenopausal" state. However, one apparently "postmenopausal" patient later showed hormonal evidence of ovulation, indicating fluctuation in ovarian function. There were 7 patients with "indeterminate" hormone profiles whose ovarian function was difficult to assess. All patients excreting more than 45 nmol of oestrogen a day had a spontaneous period within 45 days of stopping hormone therapy.

Adult

Problems in using basal body temperature recordings in an infertility clinic.

Basal body temperature recordings are extensively used to diagnose and treat infertility, but too great an emphasis on the interpretation of these charts might be counter-productive in managing these patients. Several gynaecologists who use temperature charts clinically were asked to score 60 charts taken from a selection of normal and infertile women, and their results were compared with those obtained by a group of non-experts. Since the full hormonal profiles had been obtained for each of the 60 charts the accuracy of the predictions could be assessed. About 80% of the temperature charts were correctly interpreted by both groups as being either ovulatory or anovulatory but the day of ovulation was predicted correctly for only about 34% of the charts. When the charts were examined retrospectively the thermal nadir was found to coincide with the luteinising hormone surge in 43% of the charts from normal subjects but in only 25% of those from the infertile patients. Predicting the day of ovulation from the temperature recording, particularly in infertile women, is clearly unjustified.

Basal Metabolism

Cervical mucus and prediction of the time of ovulation.

12 normal ovulatory women were studied during 17 menstrual cycles. The first day on which the women had increasing quantities of 0.1 ml or more clear cervical mucus (IQCCM) was closely related to the time of ovulation as monitored by basal body temperature and radioimmunoassay of serum-luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone. The results show that the time of ovulation can be predicted clinically without specialized tests by observing the day of onset of IQCCM.

Adult

Ovulatory cycle characteristics in Macaca fascicularis.

A total of 595 menstrual cycles were studied in 28 adult M. fasicularis over a period of five years. Ovulations, observed laparoscopically in 138 cycles, occurred on the left ovary 62.6% of the time. No significant effect was noted on cycle length relative to the ovulatory status of the previous cycle or the occurrence of ovulation on the same ovary in consecutive cycles. Laparoscopy had no effect on the parameters studied.

Animals

'Patient failure' as a reliability model for the 'minipill': a clinical study.

A trial was carried out in 10 healthy women to study the effects of withdrawal of treatment with 0.5 mg lynestrenol per day, for 3 successive days during the pre-ovulatory phase, on the physiological properties of the cervical mucus, vaginal cytology and pituitary and ovarian functions. In most cases, the amount, Spinnbarkeit and ferning of the cervical mucus and sperm penetration remained the same as that before interruption of treatment. In 2 women, the ferning altered to 'good' for 2 to 3 days as the amount of mucus increased slightly. Spinnbarkeit increased at the same time and sperm penetration was good. The changes in LH and FSH excretion suggested that ovulation possibly took place in 1 of the women studied. A mid-cycle oestrogen peak was seen in 2 women. No side-effects were reported during the study apart from irregular intermenstrual bleeding in 1 woman.

Adult

The concentrations of urinary oestrone-3-glucuronide, LH and pregnanediol-3alpha-glucuronide as indices of ovarian function.

Methods based upon the principles of radioimmunoassay have been developed and evaluated for the measurement of oestrone-3-glucuronide, LH and pregnanediol-3alpha-glucuronide in samples of unextracted urine. The procedures have been applied to daily urine (early morning fraction and combined 24 hour collections) from 6 women throughout one complete menstrual cycle and to serial samples from an additional 14 women who only collected early morning specimens. The results showed that there were characteristic, well-defined changes in the concentration of all 3 metabolites in both samples of urine and from all subjects. In addition, there was a reasonable correlation between the concentration of all 3 compounds in samples of early morning urine and the corresponding rates of excretion per 24 hours. These findings suggest that the procedures may be of value for monitoring ovarian function over long periods of time, without the problems of stress and inconvenience to the patient. Furthermore, the ratio of values for oestrone-3-glucuronide to pregnanediol-3alpha-glucuronide may be used to indicate the start and finish of the fertile period.

Adult

A study of peroxidase levels in human cervical mucus as an index of ovulation.

Fourteen healthy women were screened for the following parameters throughout one complete menstrual cycle: levels of urinary oestrogens and pregnanediol; levels of plasma and urinary gonadotrophins; and pH, protein content and levels of peroxidase in the cervical mucus. It was found that concentrations of peroxidase in the cervical mucus were not a reliable index of ovulation.

Cervix Mucus

On differences between the preovulatory luteinizing hormone surges of 4- and 5-day cyclic rats.

Preovulatory LH surges were studied in rats with ovarian cycles of 4 days (4d-rats) and 5 days (5d-rats). In 5d-rats the maximal peak height was about twice that observed in 4d-rats, whereas in 4d-rats peaks occurred about 1-5 h later than in 5d-rats and were much less consistently timed. From experiments in which LH releasing hormone (LH-RH) was infused into pentobarbitone-blocked pro-oestrous rats, it was concluded that (a) differences between the two types of preovulatory LH surges originate within the central nervous system, and (b) pro-oestrous LH-RH secretion may not be restricted to the period in which increased LH levels in blood were found, but may exceed this period for a considerable time.

Animals

Sialic acid concentration in the reproductive organs, pituitary gland and urine of the Indian langur monkey (Presbytis entellus entellus).

The concentration of sialic acid was determined in the reproductive organs, pituitary gland and urine of male and female langur monkeys. In the male, sialic acid concentration was lowest in the testes and highest in the epididymides. Both caput and cauda epididymides contained almost the same concentration. Castration and subsequent androgen administration did not modify the concentration of sialic acid by comparison with intact animals, suggesting that sialic acid is not androgen-dependent in the langur. There was no significant difference in sialic acid concentration in the uterus during the proliferative and luteal phases of the menstrual cycle. After ovariectomy, there was a decrease in the concentration of sialic acid in the uterus, cervix and vagina while oestrogen or oestrogen plus progesterone administration increased its concentration significantly, but not to the control level. However, the difference in concentration between oestrogen-treated and oestrogen plus progesterone-treated monkeys was not significant. There was a peak of sialic acid excretion in the urine on day 8 of the normal 22-day menstrual cycle, i.e. a day before the probable day of ovulation. In pregnant monkeys siliac acid excretion increased significantly 2 days before delivery compared with the values recorded 7 to 3 days before parturition. The part played by sialic acid during the menstrual cycle and pregnancy in the female is not clear.

Animals

Congenital malformations in mice after gonadotropin-induced ovulation.

Virgin mice were treated with gonadotropic hormones in order to induce superovulation; at term the embryos were removed by cesarean section. This treatment induced malformations (mainly forelimb defects and to a smaller extent central nervous system anomalies) as well as an altered sex ratio in the offspring. Both phenomena were statistically significant. These hormone-induced effects on the progeny were significantly dependent on both the dosage of hormones and the time (season) of administration. Because the time of administration (before mating) of gonadotropic hormones does not coincide with the critical period during embryogenic development for the teratogenic induction of malformations in the limbs and in the central nervous system (ca. 8th-12th day of gestation), the investigated defects are interpreted as of mutagenic origin.

Abnormalities, Drug-Induced

Preselective sex determination.

Preselective sex determination in ten consecutive pregnancies has been achieved by means of strict control over timing and technique of coitus which was combined with acidic or alkaline douching. Eight female and two male babies were born.

Acetates