Motoi Saito

Time of ovulation and prolonged pregnancy

Abstract In a prospective study of 110 women who were delivered of live infants following the spontaneous onset of labor, the time was calculated between delivery and (1) the first day of the last menstrual period, and (2) the day on which ovulation had probably taken place. The results of basal body temperature recordings were used to estimate the day of ovulation. Statistical analysis showed that delay of ovulation was the major contributing cause of apparent prolongation of pregnancy over 295 days.

Effect of Postovulatory Treatment with a Luteinizing Hormone-Releasing Hormone Analog on the Plasma Level of Progesterone in Women

(des-Gly-NH2(10),Pro-ethylamide9) luteinizing hormone-releasing hormone (LH-RH) (100 microgram) was administered subcutaneously once daily for 5 days during the postovulatory period in six women with regular menstrual cycles. Plasma levels of luteinizing hormone, follicle-stimulating hormone, estradiol, and progesterone were measured daily by radioimmunoassay from the ovulatory stage to menses. Suppression of plasma progesterone occurred during the treated luteal phase as compared with that of the control luteal phase. This finding suggests that repetitive, massive, endogenous luteinizing hormone or massive, exogenous, LH-RH itself during the early luteal phase of the cycle may induce functional luteolysis.

Effects of Japanese Kampo Medicine on Hypothalamic-Pituitary-Ovarian Function in Women with Ovarian Insufficiency

Twenty-five women who suffering with either amenorrhea, anovulatory cycle or luteal phase dysfunction were treated with TJ-23 and TJ-106 (Japanese Kampo medicine) orally for 10 to 30 weeks. Blood was taken every two weeks prior to and during treatment and serum levels of LH, FSH, prolactin, E2, progesterone (P) and testosterone were assayed. Premarin test and LH-RH test were examined prior to and during treatment. Of 7 women who were suffering with amenorrhea TJ-23 treatment brought about menstruation in 4 women; 3 were ovulated and TJ-106 brought about menstruation in 3 women; 2 were ovulated. Of 4 women with anovulatory cycle TJ-23 or TJ-106 treatment brought about ovulation in 2 women. Of 10 women with luteal phase dysfunction TJ-23 treatment brought about normal midluteal P levels in 7 women; 4 among them were pregnant, and TJ-106 brought about normal P levels in 6 women; one of them was pregnant. Improvement of hypothalamic-pituitary function was suggested during treatment by Premarin test and LH-RH test. These evidences infer that TJ-23 and TJ-106 may exert their effect on hypothalamic-pituitary area and may activate ovarian function; however, direct effect on ovary and factors except endocrine mechanism may not be excluded.

Site of Ovulation and Ectopic Pregnancy

Abstract. In a study of 130 tubal pregnancies the relationships as to location of the corpus luteum, the implantation site, and the gross findings of the non‐pregnant fallopian tube were analyzed. A contralateral corpus luteum was found in 20% of the cases. Hydrosalpinx, peritubal adhesions and/or thickening of the tubal wall were observed in 33% of the non‐pregnant tubes. Grouping by implantation site—ipsilateral or contralateral corpus luteum—showed no statistical differences. The incidence of chronic pelvic inflammatory diseases was no greater in the subjects above 30 years of age and those having had more than 2 pregnancies. The results suggest that “tube locking” of the ovum, sometimes a result of previous tubal inflammatory disease, sometimes a result of supposed insufficiency of tubal peristalsis. was the major cause of tubal gestation. External migration of the ovum alone may not be an important factor in the genesis of tubal pregnancy.

Effect of Toki-Shakuyaku-San on Ovulation Induced by Human Menopausal Gonadotropin in Rats

One hundred and thirty-five immature female rats were treated with Toki-Shakuyaku-San (TSS:500 mg/kg, Bwt in drinking water) beginning at 25 days of age and continuing during experimental sessions. Fifteen IU of the human menopausal gonadotropin (hMG:Gonadoryl:GNR:GNR 4 contains 4 to 1 ratio of FSH and LH) was injected intraperitoneally on the morning of 28 days of age, and ovulation (presence of tubal ova) was examined on the morning of 29, 30 and 31 days of age. GNR 4 alone induced ovulation at 29 days of age (70%) and at 30 days of age (35%); however, no ovulation was observed at 31 days of age. TSS treatment alone causes 30% to ovulate at 31 days of age. When GNR 4 was combined with TSS treatment, animals demonstrated ovulation at 31 days of age, that is, they ovulated at 29 days of age (93%), at 30 days of age (30%) and at 31 days of age (90%). These results infer that TSS treatment may accelerate the chain of events in the neuroendocrine control on ovulation, thus causing more frequent ovulation in rats.

Neuroendocrine Effect of Toki-Shakuyaku-San on Ovulation in Rats

In this study, the experiments were designed to examine if Toki-Shakuyaku-San (TSS) has a neuroendocrine effect on ovulation. TSS (500 mg/kg Bwt in drinking water) was given to Sprague Dawley immature female rats on 25 days of age and during experimental sessions. Fifteen IU of the hMG (Gonadoryl 4; GNR 4) was injected intraperitoneally on the morning of 28 days of age, and ovulation occurred in 70% of rats on the following day. In TSS drinking immature female rats, administration of GNR 4 on 28 days of age results in ovulation twice: once on 29 days of age and again on 31 days of age. Administration of sodium pentobarbital (Nembutal) at 12:30 p.m. on 28 days of age did not block the first ovulation on 29 days of age, but administration at 12:30 p.m. on 30 days of age blocked the second ovulation on 31 days of age. However, delayed ovulation was observed on 32 days of age. This evidence indicates that GNR 4 acts on the ovary directly and induces first ovulation in TSS treated rats. However, TSS treatment modulates the chain of events in the neuroendocrine control of ovulation and results in the second ovulation.

Effects of Anterior Hypothalamic Deafferentation on Plasma LH Response to LH-RH in the Baboon

We reported previously that a biphasic LH release (within 30 min and 90 approximately 150 min after LH-RH injection) was observed in normal menstruating baboons (non-human primates). Plasma immunoassayable LH-RH reached a maximum within 4 min after injection and was undetectable within 60 min. Plasma estrogen and progestin were elevated within 45 min. No plasma LH release with increment of plasma estrogen and progestin was observed in saline injected baboons. This study was performed to investigate the mechanism of biphasic LH release by LH-RH injection. Synthetic LH-RH (100 microgram) was injected sc into four female retrochiasmatic deafferented baboons. Blood samples collected 30 and 2 min before injection and 5, 10, 15, 30, 45, 60, 90, 120, 150 and 180 min after injection were assayed for LH, estrogen and progestin. In four baboons plasma LH peak was observed within 30 min after injection and plasma estrogen and progestin were elevated within 45 min. However, plasma LH peak within 90 approximately 150 min was not observed. These results infer that exogenous LH-RH exerts an effect on the pituitary to release LH within 30 min after injection. Increased estrogen and progestin exert the effect on the higher brain area (extrahypothalamic area) and the anterior hypothalamus to facilitate release of endogenous LH-RH, which subsequently release LH within 90 approximately 150 min in cooperation with exogenous LH-RH which may be considered to participate LH synthesis in the pituitary. Thus, it seems likely that the extrahypothalamic area (for example; limbic system) and the anterior hypothalamus have an important role in regulating LH-RH secretion and subsequent LH release in the baboon.

Direct ovulatory response with human menopausal gonadotropin of FSH/LH ratio 4 to 1.

The experiment was designed to examine if human menopausal gonadotropin (Gonadoryl, GNR, Mochida, Tokyo) influences the ovary and induces ovulation. When fifteen I.U. of GNR 4 (the ratio of FSH to LH is 4 to 1) was given on 28 days of age to immature female rats, ovulation was observed within 24 hours. Neither administration of GNR 1.6 (FSH to LH ratio is 1.6 to 1) nor GNR 3.1 (FSH to LH ratio is 3.1 to 1) induced ovulation. Administration of sodium pentobarbital (Nembutal) on the afternoon in GNR 4 treated rats did not block ovulation. It infers that GNR 4 acts on the ovary directly and induces ovulation within 24 hours.

VAGINAL REPAIR IN THE RADICAL OPERATION FOR CERVICAL CARCINOMA

An attempt was made to preserve postoperative sexual function and the recovery of bladder function by a simple modification of technique in 22 cases of radical operations for invasive carcinoma of the cervix. The procedures consisted of two parts. After removal of the specimen, the bladder peritoneal flap is sutured to the anterior vaginal wall leaving a 2 to 3 cm margin between the line of suture and the edge of the peritoneum. Similarly, the posterior peritoneal flap is sutured to posterior vaginal wall leaving a margin. Both edges of the peritoneum are then closed forming a pouch as an extension of vaginal canal. The length of the vagina was successfully elongated by this procedure, thus adding to better postoperative sexual function.

Mechanism of Contraceptive Effect With Postovulatory Estrogen Treatment

Postovulatory estrogen treatment has been shown to be an effective method for contraception in both women and monkeys. Recently postovulatory plasma LH peak has been observed in the normal menstrual cycle of the baboon. This study was designed to obtain information on the relationship between postovulatory LH and luteolysis. Blood samples and vaginal smears were obtained at 0800 hr daily in both control and treatment cycles of four adult female baboons. Plasma levels of estradiol, progesterone and LH were determined. In the treatment cycle, 300 jig of estradiol benzoate (EB) (Progynon, Schering) was given sc twice daily at 0800 and 1600 hr beginning the day after the expected day of ovulation and continuing for 5 days. Plasma levels of estradiol were maintained over 500 pg/ ml during the EB treatment period which exceeded the control preovulatory plasma estradiol peak (300-420 pg/ml) by about 400-600 pg/ml. The length of the luteal phase during the treatment cycle was shortened in one of the four baboons. In the control cycle both a preovulatory LH peak and a postovulatory (1-3 days following ovulation) LH peak were observed. In three of the four baboons, there was both an increase in the plasma LH concentrations and a premature decline in plasma progesterone concentrations during the EB treated luteal phase as compared to those during the control luteal phase. In one baboon,