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Query: UMLS:C0003128 (anovulation)
 1,718 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:[Clinical experimental studies in the treatment of ovarian dysfunction with bromo-ergocryptin (pravidel) (author's transl)]. 68 May 50

Infertility has a 30-40% incidence in women with endometriosis. However, conservative surgical procedures can result in pregnancy for 40-90% of these patients. The pregnancy rate is influenced by 5 factors: 1) extent of the disease, 2) age, 3) history of previous surgery for endometriosis, 4) duration of infertility before surgery, and 5) length of postsurgical follow-up. The factor responsible for infertility among women with endometriosis is believed to be an inadequacy of the tubo-ovarian motility secondary to fibrosis and scarring, which results in imperfect ovum acceptance by the fimbriae. Therapy encompasses 4 approaches: 1) prophylaxis, 2) observation and analgesia, 3) suppression of ovulation, and 4) surgical treatment. Pregnancy is suggested as the optimal prophylactic treatment for endometriosis since the symptoms and signs regress during gestation and for varying periods thereafter. This regression is probably due to a combination of anovulation and amenorrhea caused by adenohypophyseal suppression. It may also be due to a transformation of functioning endometriotic tissue into decidua by increasing levels of chorionic estrogen and progesterone. If pregnancy is not desired, anovulation can be secured by the administration of sex hormones. Pseudopregnancy for 6 months, induced by norgestrel plus ethinyl estradiol or norethynodrel plus mestranol, can lead to pregnancy in 50% of patients whose only abnormality is surface ovarian endometriosis within 1 year of cessation of therapy. Short periods of pseudopregnancy are also advocated after conservative surgery if all areas of endometriosis cannot be excised. 40-50% of these patients can expect to become pregnant within 24 months. The incidence of postoperative tubo-ovarian adhesions may be diminished by use of dexamethasone and promethazine.
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PMID:Management of endometriosis in the infertile patient. 80 66

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.
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PMID:Failure of positive feedback. 82 10

One hundred and one patients with polycystic ovary syndrome (PCO) were treated during an 11-year interval. Sixty-seven cases were classified as typical PCO with enlarged ovaries of probable ovarian origin (Type I) and 34 as atypical PCO of probable adrenal origin (Type II). Fifty-five patients were treated for anovulatory infertility with clomiphene citrate or other endocrine therapy as indicated. There was a 91% ovulatory response and 51% conception rate from therapy in cases of Type I PCO. In Type II PCO, adrenal suppressive therapy resulted in a 55% ovulatory response. Our data support the concept that anovulation of ovarian origin as seen in PCO Type I responds to clomiphene therapy, while anovulation secondary to adrenal hyperandrogenization should be treated by adrenal suppressive therapy.
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PMID:Clinical aspects of the polycystic ovary syndrome. 85 May 68

Two hundred and fifty-five women received clomiphene citrate during a 10-year period. Fifty-six were treated diagnostically and one hundred and ninty-nine therapeutically for infertility. It is concluded that clomiphene may aid in confirming the diagnosis and establishing a prognosis in patients with primary or secondary amenorrhea. The success of clomiphene therapy in patients with anovulatory infertility is related to the etiologic factor responsible for the anovulation, but results can be improved by adjustment of the therapeutic regimen used. In the present series, 48% of the patients who ovulated became pregnant, and 25.3% of the pregnancies were miscarried. Those patients who ovulated spontaneously and became pregnant after having discontinued clomiphene therapy showed only a 10% abortion rate. A review of the results indicates that both the ovulation rate and the pregnancy rate can be improved if adjustments are made in therapy to ensure normal follicular maturation and corpus luteum function.
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PMID:The use of clomiphene citrate. 87 51

The purpose of this study was to investigate adrenal function in rats during the development of persistent oestrus to determine whether a change in blood levels of corticosterone would precede or coincide with the onset of infertility. The syndrome of delayed persistent oestrus and anovulation was induced by administration of a low dose (10 mug) of testosterone propionate (TP) at 5 days of age. Control animals were handled without injection or received the vehicle (sesame oil) only. Half of each group was ovariectomized at weaning and received Silastic implants of either oestradiol benzoate (OB) or cholesterol, 3 mm tube length/100 g body weight. Intact rats given the low TP dose showed precocious vaginal opening (27.3 +/- 2.1 days v. 37.6 +/- 2.4 (S.E.M.) days in unhandled controls) and ovulated within 2 days. Persistent vaginal cornification developed in 22 out of 26 rats by 75 days of age. The TP-treated rats had higher corticosterone values than the controls and did not show a further increase after OB implantation. Cholesterol implantation depressed corticosterone levels in the TP-treated rats. The effects of the low TP dose were not dependent upon gonadal function since they persisted in ovariectomized rats. The results suggest that early exposure to androgen can modify the sensitivity of the adrenal system to oestrogen, and can also lead to persistently high values of corticosterone which are not depressed by ovariectomy. These changes precede the onset of persistent oestrus.
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PMID:Serum corticosterone in rats with delayed anovulation. 98 5

This report represents a summary of our experience with 171 unselected cases of artificial insemination by donor (AID) over a 4-year period. It must be stressed that the study was retrospective and subject to many of the problems of analyzing such data. However, the information gained may aid the clinician in his approach to candidates for AID. The most critical points revealed by the survey are as follows: 1. Age, length of infertility, and proven fertility, within certain limitations, appear not to be of prime importance in determining the outcome of AID. 2. Of those patients conceiving, the majority will do so within three cycles of exposure, and 90% will have done so within six cycles of exposure. 3. An adequate trial of AID therapy should last at least 6 months. 4. Although the frequently reported conception rate of up to 70% may be expected in patients with correctable anovulation or with normal reproductive organs, a marked diminution in the success rate should be expected in candidates with disorders such as endometriosis, tubal disease, pelvic adhesions, and uterine abnormalities.
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PMID:Artificial insemination using donor semen: a review of 171 cases. 124 58

Over an 8 year period, 350 cases of endometriosis (77 per cent confirmed histologically) from the Department of Obstetrics and Gynecology, Baylor College of Medicine, were reviewed. Of these cases, 58 (17 per cent) exhibited significant anovulation as measured by a scoring system. Endometriosis and anovulation can coexist contrary to classic concepts of these diseases. Both infertility factors required treatment to achieve pregnancy. A 43 per cent pregnancy rate reflects the dual infertility problem.
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PMID:Endometriosis and anovulation: a coexisting problem in the infertile female. 127 31

We used clomiphene and dexamethasone in 40 infertile women to treat chronic anovulation resistant to the use of clomiphene alone. Eighteen (45%) of the women had the polycystic ovary (PCO) syndrome; the remaining 22 (55%) had clomiphene-resistant anovulation from idiopathic causes. Both groups of women were similar in regard to age, parity, duration of infertility and absence of other causes of infertility besides chronic anovulation. Ovulation could be induced in approximately 90% of the women in each group. Altogether, 19 of 36 women (52.8%) conceived without any side effects or complications. The cumulative probability of conception at nine months of treatment was 87.5% in PCO patients and 46% in the non-PCO group. Clomiphene plus dexamethasone was highly effective in the treatment of clomiphene-resistant anovulation associated with infertility in women with and without the PCO syndrome.
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PMID:Clomiphene-dexamethasone treatment of clomiphene-resistant women with and without the polycystic ovary syndrome. 156 4

Evaluation of gonadotropins, prolactin, and thyroid function in anovulatory women directs subsequent therapy. Treatment should be initiated with the agent that is the safest and least costly for the specific indication. Except in cases of FSH elevation, pregnancy rates should approximate those of normally ovulating women. Bromocriptine, the drug of choice for hyperprolactinemia, restores ovulation in greater than 90% of women treated. Clomiphene citrate remains the drug of choice for normoestrogenic anovulation. Although drug-resistant women may respond to extended regimens, failure to ovulate or to conceive within six ovulatory cycles with clomiphene is an indication for menotropin therapy. Menotropins and pulsatile GnRH should be considered first line therapy for women with hypogonadotropic anovulation. When using hMG or pulsatile GnRH in clomiphene-resistant patients, pretreatment with GnRH analogs may normalize their response and result in higher pregnancy rates. GnRH analogs prevent premature luteinization in hMG-induced in vitro fertilization and gamete intrafallopian transfer cycles, resulting in lower cancellation rates and improved oocyte quality. Superovulation with clomiphene citrate should be attempted in patients with unexplained infertility prior to using menotropin therapy.
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PMID:Ovulation stimulation and induction. 157 83


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