摘要:

Fourteen normal volunteers were studied during one menstrual cycle. Follicular development, the luteinizing hormone (LH) surge, and the relationship between LH and progesterone secretion in the luteal phase were studied to determine the factors that control corpus luteum function. Follicular development was assessed by measuring follicle size and daily estradiol (E2) levels; the LH surge was quantified by determining the area under the curve. Although there was a significant positive correlation between mean follicle diameter and E2, these same parameters did not correlate with postovulatory progesterone secretion; nor did the LH surge correlate with progesterone secretion. A decrease in LH pulse frequency occurred in moving from the follicular to the luteal phase. There was a trend toward an increase in the late luteal LH pulse frequency compared with the midluteal phase, but this was not significant. Progesterone was secreted in an intermittent (pulsatile) fashion in the midluteal and late luteal phases. The general decrease in progesterone in the latter days of the menstrual cycle appears to be due to a decrease in the progesterone pulse amplitude. A significant correlation between LH and progesterone was present when the data were “smoothed”; however, there was not a significant synchrony for LH and progesterone pulses for most of the subjects when the initial data were analyzed by objective criteria. Progesterone secretion in the luteal phase is quite complex and leads to highly variable serum levels of progesterone when samples are obtained at random from normal women.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Corpus luteum activity was monitored in 20 women undergoing nonsurgical management of ectopic pregnancy with methotrexate and citrovorum factor (N=15) or observation (N=5). The functional integrity of the corpus luteum was assessed by measuring progesterone and 17-hydroxyprogesterone. Trophoblastic viability was assessed by measuring the immunoreactive beta subunit of human chorionic gonadotropin. Ten of 15 methotrexate-treated patients demonstrated initial progesterone levels above 1.0 ng/mL, declining to levels below 1.0 ng/mL after treatment. Five of 15 methotrexate-treated patients and all five managed by observation alone demonstrated progesterone and 17-hydroxyprogesterone values below 1.0 ng/mL both initially and throughout the surveillance period, leading to resolution, indicating previous death of the corpus luteum. We conclude the following regarding ectopic pregnancy: 1) Corpus luteum function declines early in the biologic history of some gestations while persisting in others, and 2) corpus luteum function varies from active to inactive independent of serum levels of immunoreactive beta-human chorionic gonadotropin.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Seventeen healthy postmenopausal women who had subjectively noted eight or more hot flashes per day and who objectively demonstrated four or more vasomotor flushes of 1.0C or more during eight hours of continuous thermography were studied. They were randomly allocated in a double-blind fashion to either 50 µg/day of transdermal estradiol (E2) patch or placebo. Application of the first patch was followed immediately by repeat eight-hour thermography, with hourly measurements of E2 and luteinizing hormone (LH). In the transdermal E2 group only, significant elevations of E2 (mean 91 pg/mL) were noted at two hours, and LH was suppressed after eight hours (P< .05). There was no immediate effect on vasomotor flushes. Treatment was continued for six weeks, with daily subjective recording of hot flash frequency. Patients on transdermal E2 reported a significant (P< .001) fall in hot flashes over four weeks, after which the rate stabilized. An initial decline in the placebo group was not statistically different from baseline. Eight-hour thermography was repeated after six weeks of treatment. Patients on transdermal E2 demonstrated an 85% decrease from baseline in vasomotor flushes (P< .01). No effect on total cholesterol or its subfractions, renin substrate, or aldosterone was found. Serum E2 levels fell by 50% in 24 hours after patch removal. Endometrial histology and vaginal cytology showed an estrogen effect.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Thirty adult patients with gonadal dysgenesis were identified over the five-year period between January 1981 and December 1985 in the Reproductive Endocrinology and Infertility Clinic at the University of Southern California/Los Angeles County Medical Center. Six patients had previous menstrual function and presented with secondary amenorrhea. Chromosome analysis revealed three patients with 45,X karyotypes and three patients with 45,X mosaics. One of these patients (45,X/47,XXX) presented with secondary amenorrhea and elevated follicle-stimulating hormone, and conceived twice after being placed on estrogen replacement therapy. Three additional patients presented with hirsutism as their primary complaint, and had karyotypes of 45,X/46,XY, 45X/46X,i(Yq), and 45,X. The latter patient, who had her karyotype confirmed by analysis of four tissue sources, had a streak gonad and a dysgenetic gonad, with both follicles and seminiferous tubules.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

An antisperm antibody enzyme-linked immunosorbent assay (ELISA) that uses whole unfixed sperm and detects immunoglobulin G (IgG) and IgA antibodies in serum was developed. Donor sperm were washed and plated on poly-L-lysine-treated microtiter plates. The patient's sera were diluted to concentrations of 1:4 to 1:256 and incubated with sperm. Positive and negative sera had been previously tested for IgG antisperm antibody activity with a radiolabeled antiglobulin assay. Samples were considered positive when the mean absorbance of triplicate wells was greater than 2 SD above the pooled negative mean. Intra-assay variation was 7.9 and 9.6% for pooled negative and positive controls, respectively. Identical titers of control positive serum were consistently detected. A correlation of 0.83 was observed between ELISA IgG serum titers and radiolabeled antiglobulin results (N=12). All negative samples tested negative in both assays (N=21). Some serum samples showed IgA antisperm antibodies. Determination and titration of class-specific antibodies in serum should facilitate initial screening and follow-up of patients at risk for antisperm antibodies.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Seventy-four men of infertile couples, for whom a female infertility factor had been excluded, were followed for up to three years after semen analyses that included the sperm penetration assay, an in vitro test of sperm function. At 156 weeks after a normal sperm penetration assay, the cumulative pregnancy rate was 68%, versus only 27% when an abnormal assay was noted. Cumulative pregnancy percents at one year varied significantly (P< .02) according to the magnitude of the assay result (0%, 1-10%, 11-15%, 16% or greater). However, differences between 0% versus 1-10%, and 11-15% versus 16% or greater, were not statistically significant. Only one of 14 men effected conception after an assay result of 0%. These findings were little altered when analysis of the sperm penetration assay was restricted to men with normal sperm concentration (20 x 106sperm mL-1or greater) and motility (60% or greater). The presence of pyospermia (six or more white blood cells per 100 spermatozoa) was associated with continued infertility, but neither abnormal sperm concentration nor motility were associated significantly with lower cumulative pregnancy percents. When performed for infertile men according to standard protocol, the sperm penetration assay enhances prediction of future pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Studies examining the increased surgical morbidity among obese gravidas have focused mainly on differences in outcome between obese and nonobese mothers. Little is known, however, about the cause for worsened operative outcome in obese mothers or the potential impact of perioperative interventions. To define more precisely the clinical determinants of postoperative morbidity, multivariate analysis was used to relate antepartum and intrapartum variables to three measures of morbidity in 107 consecutively delivered obese women undergoing cesarean. Although obesity is clearly an operative risk factor, this study suggested that among obese gravidas, varying degrees of maternal obesity and accompanying medical complications, such as diabetes and hypertension, were not associated with greater operative morbidity. Furthermore, neither choice of skin incision nor type of anesthesia appeared to be related to operative morbidity. However, two factors potentially under the control of the clinician, increased length of surgery and operative blood loss, were associated significantly with measures of operative morbidity. A finding of worsened outcome with prophylactic antibiotics and heparin requires further study.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Loss of intestinal lactase activity among adults could theoretically limit milk consumption and hence dietary availability of calcium during pregnancy. The present study sought to define, using breath hydrogen (H2) production as an index of incomplete carbohydrate absorption, the prevalence during pregnancy of lactose maldigestion of 360 mL of milk (18 g of lactose), and to determine whether lactose digestion improved as pregnancy advanced. The prevalence of lactose maldigestion among 114 pregnant women tested before the 15th week of gestation was 54%. By term, 44% of those originally classified as maldigesters had become digesters. There was a significant reduction in the four-hour sum of the changes in breath H2concentration from the period before 15 weeks (116 ± 9.6 ppm) to the time after 36 weeks (54.4 ± 7.3 ppm; P< .01). This apparent adaptive improvement in intestinal handling of milk lactose during gestation has implications for calcium intake and absorption.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

In a large sample (N= 7116) of women who had two pregnancies within six years, the 50th percentile of weight gain between pregnancies was 2 lb (0.9 kg). Weight gain in pregnancy, week of registration, cigarette smoking, race, percent of ideal body weight, complications of pregnancy, and marital status in the first pregnancy, as well as breast-feeding in the hospital and interval between the two pregnancies, correlated significantly with interpregnancy weight change, and explained 24% of the variance (P< .0001). Weight gain in the first pregnancy alone explained 21% of the variance in weight change between pregnancies. After adjustment for the effects of other variables on weight change, weight gains in pregnancy of 20 lb (9.1 kg) or more were statistically significant (P< .05); the more weight a woman gained above 20 lb (9.1 kg), the more she retained by the start of her next pregnancy.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

Four primiparous bulimic women were interviewed. Pregnancy outcome was not affected adversely by bulimia. Gestational age ranged from 37–1 weeks, and average infant birth weight was 3121 g. Maternal weight gain averaged 40 lb. Bulimic behaviors decreased during pregnancy, but returned to prepregnant levels after delivery in three of the four women.

ISSN:0029-7844    

出版商:OVID    

年代:1988

数据来源: OVID