Carl Gemzell

Pregnancies following treatment with human gonadotropins: With special reference to the problem of multiple births☆☆☆

Abstract During a 4 year period about 100 women with primary or secondary amenorrhea were treated for sterility with human pituitary FSH and HCG. About 90 per cent ovulated once or several times, and 50 per cent became pregnant. So far 43 have been delivered, 20 women of a single infant, 14 of twins, and 9 of triplets or more fetuses. Thus, the incidence of multiple births was the same as that of single births. Repeated pregnancies were induced in 10 patients. The rate of abortion was high in those women who conceived triplets or more while it was negligible in those with single pregnancies. No congenital malformations were observed. To avoid multiple births the daily dose of human pituitary FSH, the pattern of FSH administration and the endogenous gonadotropin production must be taken into careful consideration with each new patient. This kind of treatment is, therefore, best confined to special centers with a fully equipped gynecologic endocrine unit.

Induction of ovulation in infertile women with pituitary tumors

Four infertile women with pituitary adenoma were treated with human pituitary gonadotropins (HPG) in order to enable them to become pregnant. During pregnancy they contracted headache, bitemporal visual field defects, or impaired visual acuity. One woman was operated upon in the second trimester; the other three, as the symptoms were relatively moderate and no risk of permanent damage to the optic tract existed, went to term. After operation or delivery the symptoms disappeared.

Monophasic basal body temperature in ovulatory menstrual cycles

Abstract The plasma concentration of progesterone, the urinary excretion of estrogens, and the basal body temperature were followed in 17 normally menstruating women during 33 menstrual cycles. A monophasic basal body temperature was found in 4 cycles (12 per cent) in spite of the fact that the other parameters investigated suggested that ovulation had occurred. It is thus concluded that the registration of a monophasic basal body temperature during a menstrual cycle does not give sufficient information for the conclusion that the cycle is anovulatory.

Induction of ovulation in patients following removal of a pituitary adenoma

Abstract Five infertile women who were operated upon for pituitary adenomas were treated with human pituitary, postmenopausal, and human chorionic gonadotropins in order to conceive. Ovulation took place following each treatment. Four of the women conceived; three gave birth to twins and one to a single infant. One of the women went into labor spontaneously; three, close to term, were delivered by cesarean section. The seven children were normal and healthy.

Control of Ovulation with Human Gonadotrophins

It is through the two gonadotropins, the follicle stimulating hormone (FSH) and the luteinizing hormone (LH), that the anterior pituitary controls the timing of ovulation and the number of follicles that rupture. Under the influence of FSH, the follicular growth occurs at a constant rate for any given species (Hisaw, 1947). This rate cannot be accelerated by increasing the doses of exogenous FSH (Davis and Hellbaum, 1944). The number of follicles developing to maturity is also constant for each species but can be increased by the addition of exogenous FSH (Brambell, 1956). As each follicle seems to require a certain amount of FSH for maturation, the release of FSH from the anterior pituitary of each species may also be constant (Evans and Simpson, 1940). Thus, the amount of exogenous FSH needed for a normal ovarian response varies with different species. Too much or too little will cause too many or too few follicles to develop and mature.

Plasma Progesterone and 17α-hydroxyprogesterone measured by a Competitive Protein Binding Technique and related to the Oestrogen Excretion and LH Level around Ovulation in the normal Menstrual Cycle

Publisher Summary This chapter provides an account of plasma progesterone and 17 α -hydroxyprogesterone measured by a competitive protein binding technique and related to the oestrogen excretion and luteinizing hormone ( LH ) level around ovulation in the normal menstrual cycle. Around ovulation, drastic changes occur in the peripheral plasma concentration and urinary excretion of the gonadotrophins and ovarian steroids. This chapter discusses the relation between plasma LH, progesterone, 17 α -hydroxyprogesterone and the total urinary excretion of oestrogen during the normal human menstrual cycles. The chapter serves as the basis of the studies of the endocrinology of abnormal menstrual cycles. Plasma and urinary LH were assayed by the radioimmunosorbent technique of Wide and Porath. Antibodies to human chorionic gonadotrophins (HCG) were coupled to cyanogen bromide (CNBr)-activated Sephadex. Plasma 17 α -hydroxyprogesterone was measured by competitive protein binding.