Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003128 (anovulation)
 1,718 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Ovulation induction with human gonadotropins (hMG or pFSH and hCG) was simultaneously monitored with daily serum 17 beta-estradiol measurements and ultrasound in 38 infertile women. They were subgrouped as follows: A, hypogonadotropic hypogonadism (n. 7); B, polycystic ovary syndrome (n. 13); C, non-PCO chronic anovulation (n. 6); D, unexplained infertility (n. 12). The dose of hMG and the duration of therapy were assessed individually depending on the results of the monitoring when serum estradiol concentration was 500-1500 pg/ml and/or ultrasound showed of a follicle of at least 18 mm, hMG was stopped and hCG was administered 36 hours later. Ovulation was obtained in 61 cases and pregnancy occurred in 12 women out of 64 monitored cycles. The highest pregnancy rate was observed in hypogonadotropic hypogonadism; this group also required the greatest total dose of hMG to obtain ovulation. We confirm that women with PCOS are at increased risk with this therapy, since 5 subjects in our series showed signs of ovarian hyperstimulation in spite of the lowest total dose of FSH administered to this group. We conclude that anovulatory states of various origin are associated with different ovarian sensitivity.
 ...
PMID:Ovulation monitored by serum 17 beta-estradiol and ultrasound: differential ovarian response to human gonadotropins in various anovulatory states. 315 Aug 88

Induction of ovulation with pulsatile luteinizing hormone-releasing hormone (LH-RH) therapy was attempted in 48 women with polycystic ovary disease (PCOD) and clomiphene citrate (CC) resistant anovulation. Fourteen women ovulated regularly, 23 ovulated variably, but 11 did not ovulate at all. Fifty-two of the 108 cycles of pulsatile LH-RH therapy alone (15 mu gm per pulse, one pulse every 90 minutes) administered through the subcutaneous route were ovulatory. In patients who did not ovulate on subcutaneous LH-RH, treatment with CC (100 mg per day for 5 days) was added to the LH-RH therapy in an additional 33 cycles, of which 21 were ovulatory. In those who did not respond to the combination of treatments, the same dose of LH-RH was administered intravenously: 14 of 29 cycles of intravenous therapy were ovulatory. The overall cumulative conception rate after 6 months of therapy was 60%. When recalculated for ovulatory cycles alone it was 90%, indicating that failure of ovulation was the only cause of the failure of conception. Analysis of the clinical and endocrine findings indicated that failure to ovulate was associated with obesity and hyperandrogenization. Ten of the 23 conceptions ended in miscarriage, 8 within 4 weeks of ovulation. The authors conclude that infertility in patients with PCOD is not optimally corrected by pulsatile LH-RH therapy.
 ...
PMID:Pulsatile luteinizing hormone-releasing hormone therapy in women with polycystic ovary syndrome. 328 91

Involuntary infertility is an increasing problem in this era of delayed childbearing. Fortunately, many advances have been made recently in the medical and surgical treatment of infertility. This article reviews the principal aetiologies of infertility and their treatments, and focuses on the current and future uses of ovulation-inducing drugs and other infertility treatments. Proper diagnosis of anovulation and luteal phase dysfunction is discussed together with a description of conventional treatments with clomiphene and human menopausal gonadotrophins (hMG). Recent advances including the use of synthetic gonadotrophin hormone-releasing hormone (GnRH), purified human follicle stimulating hormone and a combination of GnRH and hMG are described, along with the application of the same agents for enhanced follicular recruitment for in vitro fertilisation. In addition, several promising future developments for pharmacological induction of normal ovulation are also discussed.
 ...
PMID:Drugs in the treatment of female infertility. Recent advances. 352 60

The frequency of short and long term complications of artificial pregnancy termination were studied to identify a group of high risk patients in relation to the development of postabortion complications. The goal was to determine the optimum time for conducting rehabilitative measures. Group 1 was composed of 250 women whose pregnancy was terminated by curettage (n=100), prostaglandins (n=100), and vacuum aspiration (n=50). Reproductive function was assessed in this group for 12 months after artificial abortion (1, 3, 6, 12 cycles). Group 2 consisted of 400 women: pregnancy was terminated instrumentally in 250 of the women, and it was done by prostaglandins in 150 women. The assessment of reproductive function was conducted 5 years after artificial abortion. Gynecological diseases were observed in 16 patients of group 1 (6.4%): in 12 of 100 women with instrumental abortion (12%), in 2 of 100 women with prostaglandin-induced abortion (2%), and in 2 of 50 women with vacuum aspiration (4%). In most of the women complications were expressed in the form of uterine subinvolution (2.4%), metroendometriosis, salpingoophoritis (2.4%), and in the form of metrorrhagia (1.6%). Followup of group 1 revealed no regularity in the time of development of the disorders since their rate of appearance was equal 1, 3, 6, and 12 months after abortion. The 1st menstrual cycle after both surgical and prostaglandin abortion was biphasic in 88% (220 of the 250 women). Yet, an insufficient luteal phase in the 1st menstrual cycle developed in 20% of women with surgical abortion and in only 10% of the subgroup with prostaglandin-induced abortion. The 2nd menstrual cycle was characterized by the recovery of hormonal parameters and tests of functional diagnosis. Examination of the 2nd group revealed reproductive dysfunction in 131 of the 400 women studied (32.7%). The primary complaint was infertility. 3 groups of disorders were identified: hypothalamopituitary dysfunction expressed in anovulation (33 women); hypothalamopituitary dysfunction manifested by insufficient luteal phase (80 women); and adnexitis (18 women). The rate of postabortion complications in the long term increased by more than 3-fold. Postabortion complications were more frequent in women with a late menarche and with a history of genital inflammation. Investigation of the menstrual pattern in women suffering from secondary infertility after artificial abortion showed that 36.6% of the patients preserved the regular menstrual pattern, yet an insufficient luteal phase revealed by functional tests led to infertility. Impairment of the ovulatory process was the leading symptom in the women with secondary infertility. Ovarian dysfunction was expressed as an insufficient luteal phase 2.4 times more often than anovulation.
 ...
PMID:Short and long-term results of pregnancy termination by different methods. 358 57

Although anovulation associated with hyperprolactinemia is not an uncommon cause of infertility, the precise mechanism of the pathogenic process that induces hyperactivity (hypertrophy with hyperplasia) of pituitary lactotropes is unknown. We have recently experienced a case of anovulation and hyperprolactinemia in a woman with ergot alkaloid intolerance in whom ovulation was restored by tamoxifen citrate administration. Since tamoxifen citrate administration also suppressed prolactin levels, it was suggested that a low but sustained serum level of estradiol and consequently continuous estrogenic stimulation may be an important causative factor in the development of hyperprolactinemic anovulation.
 ...
PMID:Evidence that estrogen may be a key factor in hyperprolactinemic anovulation: a case report. 361 80

Fifty-two women, aged from 25 to 41 years, with infertility due to chronic anovulation were admitted to the study together with 36 age-matched controls with proven ovulatory cycles. Paired plasma (3 ml) and whole unstimulated saliva (10 ml) samples were collected over a 30 day period, starting from the first day of a menstrual bleeding, in patients, and throughout the menstrual cycle, in controls. Salivary progesterone levels, measured in women with infertility, ranged from undetectable values to 16 pmol/l during the first, and from 36 to 98 pmol/l during the second half of the monitoring period. In eugonadal women the steroid levels ranged from 34 to 46 pmol/l and from 96 to 780 pmol/l during the follicular and luteal phases, respectively. The saliva/plasma progesterone ratio ranged from 0.58 to 2.71 p. cent and a good correlation between salivary and plasma levels was found at each time of monitoring. Many (86 p. cent) of patients, which were randomly allocated to a low- or high-dose epimestrol administration schedule, appeared to be sensitive to the drug, achieving, after therapy, salivary progesterone levels which were within the range of controls. Since correct assessment of luteal function in basal conditions and during therapy requires multiple steroid measurements, and since saliva can be obtained by non-invasive techniques, salivary assays represent an attractive alternative to plasma ones for monitoring ovarian activity, also during specific treatment.
 ...
PMID:Radio-immunoassay of salivary progesterone for monitoring ovarian function in female infertility. 367 48

30 Ituri women (Zaire) -- 14 Efe and 16 Balese -- were targeted as subjects in this study designed to verify that, under field conditions, the salivary steroid method can reliably discern follicular and luteal levels of progesterone in normal menstrual cycles and to examine the hypothesis that infertility among these women is due to tubal factors. Findings of normal ovulatory function in fertile women would support the hypothesis; findings of abnormal gonadal function might either indicate a chronic endocrine imbalance or the short-term effects of nutritional and other stressors. All potential subjects ranged in age between 20-35 years, were involved in stable conjugal unions, had no nursing children, and reported either no births or none within the last 6 years. 25 women completed the study. The Boston field control subjects consisted of 18 volunteers ranging in age between 18-43 years. All reported a history of regular menstrual cycles and were nither using oral steroid contraceptives nor engaged in a regular exercise program. The African women had significantly lower luteal progesterone levels than did the Boston controls. Additionally, a significantly higher proportion of the African women failed to demonstrate clear luteal activity, suggesting that a higher rate of anovulation contributed to the low average luteal progesterone levels. The composite-cross-sectional profile for the Ituri Forest women suggests that the average luteal phase for this group was shorter than for the Boston controls. Further investigations need to determine whether gonadal dysfunction such as observed in this study is a regular feature of the reproductive physiology of women in the Ituri Forest, or whether it emerges only in periods of food shortage and significant weight loss. Gonorrhea may be the major cause of infertility in the Ituri region, but it is likely that other factors directly affecting gonadal function contributed to the observed pattern of low fertility. Clearly, the study illustrates the potential usefulness of salivary steroid assays.
 ...
PMID:Salivary progesterone and luteal function in two low-fertility populations of Northeast Zaire. 375 49

The causes of secondary sterility in a couple are varied and may include a strong psychosomatic component. In this article, brief case histories are used to illustrate secondary sterility following abortion, maternal prohibition, and the death of a child. Sterility following abortion still occurs in France, but it is not always due to a tubal problem. During the 1st consultation for infertility the woman should be encouraged to describe the circumstances of the abortion, whether it was performed in secrecy, and her feelings about it. A 24-year-old woman who had had an abortion 2 years previously suffered from irregular cycles and was unresponsive to treatment to regulate ovulation. She became pregnant only after violently reproaching her mother for the mother's role in the abortion. Another woman had an extrauterine pregnancy, premature birth in which the infant died, and stillbirth after 2 induced abortions. She finally gave birth to a healthy term infant. In a 3rd case a Catholic woman of Irish origin felt such guilt after an abortion that she became pregnant again only after 10 years of infertility and an adoption. Some cases of infertility after a 1st live birth are explained by a prohibition on the part of the woman's mother, who herself had only 1 daughter. The reasons advanced by the mother for discouraging a daughter from becoming pregnant are not usually the true reasons, and the prohibition in some cases is difficult to overcome. Women who suffer the death of a child in utero or in infancy sometimes have difficulty becoming pregnant again. It is important to allow such patients to describe the circumstances of the death in detail. Usually at least 18 months must pass before the work of grieving is over. Hospital procedures which seek to shield the parents from the sight of their dead child may actually impair the grief process. A 27-year-old woman suffered secondary infertility and anovulation after the death of her 2nd child from congenital cardiac malformation. She was able to deliver a healthy child only after 2 miscarriages and a difficult pregnancy filled with anxiety, nightmares of death, and psychosomatic problems.
 ...
PMID:[Secondary sterility]. 385 91

The endocervix undergoes cyclic changes in every menstrual cycle, as reflected by the rheologic properties of the cervical mucus. A study was therefore undertaken to establish whether there were any morphologic changes in the endocervical columnar cells, as seen in the endocervical smears, that could be correlated with ovulation and anovulation. An endocervical smear was collected in the luteal phase of the cycle from patients in whom an endometrial biopsy or D & C was being done as a part of an infertility investigation. A significant correlation was observed between the endocervical smear interpretation and the endometrial histology as to whether the cycle was ovulatory or anovulatory.
 ...
PMID:The endocervical smear as a simple and quick method for the determination of ovulation. 386 Oct 57

In attempt to optimize gonadotropin-releasing hormone (GnRH) treatment of anovulation, we compared the effect of intravenous GnRH administration at three pulse intervals (PI) during 63 cycles in 30 anovulatory patients who had: (1) amenorrhea secondary to anorexia nervosa (group I: 10 patients, 21 cycles); (2) unexplained anovulation with normal to high luteinizing hormone plasma levels (group II: 12 patients, 24 cycles); and (3) polycystic ovarian disease (PCOD) (group III: 8 patients, 18 cycles). Ovulation was achieved more frequently in group I (85%) than in group II (41%) or in group III (50%). In both groups I and II, the frequency of ovulatory responses was not different with the PI used, and 6 of the 17 women treated for infertility conceived; 3 with 90-minute PIs, 2 with 64-minute PIs, and 1 with 128-minute PIs. In women with PCOD, seven of the nine ovulatory responses and three pregnancies were obtained with 128-minute PIs. The overweight women with PCOD did not respond reliably to GnRH at the doses used, i.e., 4 to 15 micrograms per pulse. In all groups, the urinary estrone and estradiol preovulatory peak, duration of luteal phase, progesterone levels, and preovulatory follicle diameter were unrelated to the frequency of GnRH administration.
 ...
PMID:Influence of the frequency of gonadotropin-releasing hormone (GnRH) administration on ovulatory responses in women with anovulation. 389 25


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>