复方复方甲孕环酯片对妇女排卵的影响

本实验对8例于月经周期第10天服用复方甲孕环酯片(100毫克)的妇女进行了尿孕二醇量测定,观察该药对排卵的影响。结果表明,4例对照妇女均正常排卵;而服药的8例中有5例未排卵,3例仍排卵,排卵抑制率为62.5%。服药后,部分排卵抑制者的月经周期缩短。本文对该药的抗生育机理进行了讨论,认为复方甲孕环酯除不完全的抑制排卵以外,还能作用于其它环节,其抗生育作用是多方面的。     

国产LRH-A经鼻喷雾间断给药法对正常育龄妇女抑制排卵作用的临床研究

28例正常健康育龄妇女,自月经来潮后第1～3天起,使用国产促黄体生成激素释放激素(LRH)的激动性类似物,[D-丙~6,去甘酰胺~(10)]-LRH 乙基酰胺(LRH-A)0.5mg/日(10例)和1.0mg/日(18例)经鼻喷雾给药,以连喷21天,停7～10天为一个用药周期的间断给药法,共观察了50个用药周期。结果发现受试者在用药期间E_2、P、和LH 水平均被抑制,无1例妊娠,停药后均能很快恢复正常的排卵周期和性激素水平,亦未见明显毒副反应,似较使用连续给药法为优,故值得临床进一步观察使用。     

【焦谷-脯~1】【D-苯丙~2】【D-色~(3,6)】-LHRH能抑制恒河猴排卵前的促性腺激素分泌

合成一些促黄体素释放激素(LHRH)的拮抗性类似物,其最终目的是用于妇女达到阻断排卵。最近报告合成了一组具有11个氨基酸的肽,这是一组强的LHRH的拮抗性类似物。其中之一为〔焦谷脯~1〕〔D-苯丙~2〕〔D-色~(3、6)〕-LHRH,已证明给大鼠应用该拮抗物(200μg/每鼠)能100%抑制排卵。作者在恒河猴观察了该拮抗物的阻断排卵作用并比较了用药时间与效力的关系。选用6只月经周期正常的健康恒河猴进行实验,3只给药,另3只作为对照。根据该繁殖群的猴正常中期促性腺激素峰平均为第十一天,以及基于测定血清雌二醇浓度,在月经周期的第七天以     

降黑素对猴雌激素分泌及黄体生成的影响

降黑素(Melatonin)是松果腺分泌的一种激素。有报道,降黑素常使食蟹猴的排卵延缓,黄体期缩短,甚至不排卵。已知导致排卵的黄体生成素的峰值,正常是受血中雌激素水平升高的促进。本文进一步分析了给猴注射降黑素的过程中和注射以后,雌激素的分泌及其与黄体机能的关系。给7只具有规律周期的猴,皮下注射10毫克降黑素。从周期的第7或第9天开始到第17天,每天清晨9—11点注射。用其中6只猴做过未用药周期的对照。在对照周期和用药的过程中,每隔一天的清晨自股静脉取血。此后,在用降黑素以后的第1     

复方甾体长效口服避孕药对妇女血脂影响的前瞻性研究

本文对36例育龄妇女随机服用左旋18甲基炔诺酮6mg或消旋18甲基炔诺酮12mg与炔雌醚3mg配伍的长效口服避孕药,观察脂代谢的变化。于服药前、服药后6、12周期及停药后1、6周期系统观察血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(IDL—C)、低密度脂蛋白胆固醇(LDL—C)及载脂蛋白APOA—I与APOB的变化。结果表明:随服药周期的延长,两种避孕药均使血清TC、TG、HDL—C、APOA—I、APOB升高,停药后逐渐下降,半年时趋近于服药前水平。两种药对血脂的影响无差异。     

女用长效口服避孕药——复方炔雌醚对子代生长发育的影响

<正> 复方炔雌醚是六十年代末由我国配伍制成的女用长效口服避孕药。每片含炔雌醚2mg,氯地孕酮6mg,18-甲基炔诺酮6mg,每月服一片,避孕一个月,七十年代初开始实验室与临床研究,迄今已历时15年之久。此药有抑制排卵的作用,其避孕效率按妇女年计算达97.06%,多数人在停药3～6个月内恢复排卵,生育功能迅速恢复。有部份服药妇女受孕后继续妊娠,分娩了相当数量的子代。为了研究药物的安全性及阐明药物对后代的影响,本文于1984～1985年收集上海地区曾服此药的妇女所生育的子代236名进行了生长发育并各系统的检查。     

醋炔诺酮肟避孕片对子宫内膜组织学和阴道细胞学的影响

本文报告了38例服醋炔诺酮肟避孕片(其中26例服探亲片、12例服事后片)和3例不服药的健康妇女的子宫内膜活检结果及11名服酮肟探亲片妇女12个周期的阴道细胞学观察结果。所有服药妇女的子宫内膜发育均受不同程度抑制,对在周期早期开始服药者内膜的抑制作用较后期服药者明显。表明药物干扰了内膜的发育和分泌,这可能是该药避孕作用的主要机理。阴道细胞学检查表明,服药后阴道细胞因保持较低的雌激素影响而缺乏正常的周期变化,提示在周期的早期开始服药可能抑制排卵。     

诱发排卵前给予GnRHa时间的长短并不影响卵巢对GnH的反应性

GnRHa诱发排卵的作用依赖于开始给药的时间,在刺激周期早卵泡期给药,GnH分泌骤增,对卵泡募集和发育有益;于上周期的黄体期开始给药,则会导致功能性低GnH性腺功能低下状态(降调节),这使开始诱发排卵的时间有很大的伸缩性。GnRHa降调节对下个周期诱发排卵中卵巢反应性的影响问题一直未得解决,本文就此问题进行探讨。 在18个月内对165名年龄<40岁,CC反应正常且已证实有排卵周期妇女进行助孕治疗。在诱发排卵前于黄体期开始用Leuprolide acetate(LA)1mg/日Sc,LA的预治疗期限各患者不一致,有     

宫颈评分监测氯菧酚胺诱发排卵的评价

本文分析33例无排卵患者应用氯菧酚胺治疗76周期中宫项评分(CS)与BBT、卵泡发育及激素参数的关系。19个周期无排卵反应,CS波动,但宫项粘液透明性状不变。57个周期有排卵反应,其中32周期停药后CS渐进增高,最高宫颈评分MCS≥8,卵泡发育好,LH峰后24h内排卵;22周期MCS<8,LH峰后卵泡不消失,形成LUF,激素测定提示停药后睾酮水平明显升高;另三个周期资料不全。结果提示停药后未见药物在宫颈水平的抗雌素效应;睾酮升高可能干扰CS并导致LUF。     

生殖免疫学与免疫避孕(三)

<正> 四、雌雄抗原及胚胎抗原从生物学的观点来看,从雌性抗原或胚胎抗原来研究免疫避孕,思路似乎更宽广些。(一) 垂体及下丘脑激素1.黄体生成激素释放激素(LHRH): 该激素是10肽,免疫原性弱。将LHRH结合于牛血清白蛋白和适当的佐剂免疫猴、兔、鼠、狗等动物可获得有效的抗LHRH作用,从而抑制LH和FSH,但对垂体产生的催乳激素和促甲状腺激素无任何影响。以家兔抗-LHRH血清被动免疫小鼠和猴可以抑制排卵。Hodges等对狨猴进行的抗-LHRH自动免疫的试验说明对排卵和受精的抑制是可逆的,当抗体滴度高时,排卵和受精被抑制;     

Effect of a specific estrogen antibody on pregnancy establishment in the bonnet monkey (Macaca radiata)

The requirement for estrogen for pregnancy establishment has not been conclusively demonstrated in primates. Selective neutralization of estrogens was achieved in mated female monkeys during preimplantation and postimplantation periods by injecting characterized estrogen antiserum from either day 14 to 18 or day 28 to 32 of cycle. While estrogen deprivation during preimplantation period in 5 animals exposed to 14 ovulatory cycles resulted in only one pregnancy, only 3 of 13 monkeys treated during postimplantation period continued pregnancy to term. In comparison with controls (4 of 5 monkeys becoming pregnant), the percent protection against pregnancy in animals treated during preimplantation period was 93. The pregnancy termination in 10 of 13 monkeys treated during postimplantation period when compared with normal postimplantation pregnancy wastage in our colony (2%) is also highly significant (P less than 0.01). The present study demonstrates a critical need for estrogen during the peri-implantation period for a successful pregnancy establishment in primates.     

NORPLANT皮下埋植避孕剂使用的有效性及其副反应的评价

本研究于1984年10月至1987年9月应用Norplant皮下埋植剂1470人(其中Nor-Plant-Ⅰ1169人,Norplant-Ⅱ301人)控制生育。12个月和24个月的避孕效果:累积的妊娠率分别为0.2%和0.3%,持续使用率分别为96.5%和86.2%。主要副反应:月经不规则是终止使用的主要原因;但总失血量不多。Norplant埋植剂使用1年和2年后测定血红蛋白均值略有升高;血压无变化;体重略有增加。埋植剂的放置和取出易于掌握,在1470名使用者中未发生感染或其他并发症,使用安全。由于其妊娠率低和不可能脱落及其高度可逆性,深为受试者所欢迎。     

Effect of chronically elevated androgen or estrogen on the glucose tolerance test and insulin response in female rhesus monkeys

Insulin concentrations, in response to an intravenous glucose bolus after a 24-hour fast, have been studied in female rhesus monkeys in which the circulating levels of androstenedione and testosterone or estrone and estradiol have been increased for as long as 4 1/2 years. No significant differences were observed in the basal insulin or C-peptide concentrations in the androgen or estrogen-treated animals compared with each other or with normal cycling, nontreated control animals. The insulin and C-peptide responses to intravenous glucose were similar in control and androgen-treated monkeys. Compared with both the control and androgen-treated monkeys, the responses of the estrogen-treated monkeys tended to be lower but were not significantly different. The glucose disappearance rate after the intravenous glucose bolus was not significantly different in androgen and control monkeys but was significantly slower during the initial 30 minutes in the estrogen-treated monkeys compared with both the control and androgen-treated monkeys. These studies suggest that chronically elevated androgen levels in the mature female subhuman primate do not lead to insulin resistance or overt glucose intolerance.     

Pregnancy suppression in the bonnet monkey by active immunisation with chicken riboflavin carrier protein

Five healthy female bonnet monkeys (Macaca radiata) of proven fertility and normal menstrual cyclicity have been actively immunised with the purified chicken egg white riboflavin carrier protein (cRCP). All the immunised animals exhibited specific antibodies to cRCP and the immunopotencies of their sera varied from 200 to 840 micrograms/ml at equivalent point. A definite fraction of antibodies in these sera specifically recognised the purified and 125I-labelled monkey RCP. Immunisation per se had no adverse effect on the animals' menstrual cyclicity, circulating levels of estrogen and progesterone and the riboflavin status as reflected by glutathione reductase activities and the total flavin contents of the erythrocytes. The fertility of these animals was monitored for a period extending up to 3 years after primary immunisation. Four out of the five animals exhibited termination of pregnancy once or more than once depending on their antibody titers. Towards the end of the study period, when the immune response was poor, all the animals delivered normal babies at term. Circulating anti-cRCP antibodies were monitored by 125I-labelled cRCP binding. The results show that pregnancy termination, owing to immuno-neutralisation of monkey RCP, occurred only in animals which had sufficiently high antibody titers. If the titers fell below a critical threshold level the pregnancies were carried to term.     

Effect of intranasal administration of norethisterone and progesterone on pituitary and gonadal function in adult male and female bonnet monkeys (Macaca radiata)

The effect of intranasal spray of norethisterone (NET) and progesterone (P) on serum testosterone (T) and total sperm count in adult male bonnet monkeys and the effect of NET spray on the menstrual cycle in female monkeys has been studied. Whereas NET spray resulted in a drastic decrease in serum T levels and sperm count, P spray caused a decrease in total sperm count only. Intranasal spray of NET in adult cycling female monkeys between days 5 and 14 resulted in shortening of the menstrual cycle; this could be ascribed to a decrease in serum follicle-stimulating hormone, luteinizing hormone, 17 beta-estradiol, and P levels. Nasal spray of only solvent in male or female monkeys, however, had no effect on any of the parameters tested.     

A randomized trial of three copper IUDs (MLCu250, MLCu375 and Nova-T)

A randomized prospective trial of three copper IUDs, Nova-T, MLCu375 and MLCu250, including 200 of each, is presented. Insertion was done at the hospital outpatient clinic on normally menstruating women and on women in puerperio. Follow-up was scheduled after 12, 24 and 36 months. Pregnancy rates were low for all 3 models. Pearl indices after 3 years were 0.5, 0.9 and 0.8 for Nova-T, MLCu375 and MLCu250 respectively (NS). Abnormal bleeding and/or pain was the most frequent termination cause. Minor differences in the termination rates because of abnormal bleeding and/or pain were found and are discussed. The continuation rates based on all medically relevant IUD removals were 74%, 73% and 81% after 3 years for Nova-T, MLCu375 and MLCu250 respectively. No important difference in clinical performance between the three copper IUDs could be demonstrated.     

The effects of prenatal diethylstilbestrol (DES) exposure on the genitalia of pubertal Macaca mulatta. I. Female offspring.

Nineteen pregnant female rhesus monkeys (Macaca mulatta) received 1 mg/day diethylstilbestrol (DES) over three time periods during gestation: day 21 to delivery (group I), day 100 to delivery (group II) and day 130 to delivery (group III). Seven females and five males of a total of 20 offspring are presently alive at 5 1/2 years of age; one female died at 5 years of age. No deaths have been shown to be treatment related. In female offspring, menstruation began at about 2 1/2 years of age, was irregular for approximately one and one-half to two years and then became regular. Vaginal ridging and/or cervical hooding have been observed in seven of the eight DES-exposed females, and three had histologically demonstrable vaginal adenosis. None of the anomalies was related to a specific treatment period, for they appeared in all treatment groups, nor did they occur in the age-matched controls. Furthermore, none of the animals, either treated or control, showed any evidence of adenocarcinoma. Therefore, exposure of Macaca mulatta females to DES in utero appears to be teratogenic, but thus far no carcinogenicity has been observed. Reports in humans indicate that adenocarcinoma is an additional manifestation of prenatal exposure to DES; also, treatment effects appear to be more commonly observed in individuals exposed during the early stages of gestation. From this viewpoint, the rhesus monkey is a potentially valuable model for the study of vaginocervical anomalies and adenosis, but it is premature to consider it a suitable model for the study of adenocarcinoma.     

Qualitative and quantitative changes of luteinizing hormone (LH) in the pituitary glands in female Japanese monkeys (Macaca fuscata) during the menstrual cycle and after castration

The present study was designed to investigate qualitative and quantitative changes in luteinizing hormone (LH) in the pituitary glands of female Japanese monkeys (Macaca fuscata) during the menstrual cycle and after castration. The pituitary glands were removed from 10 intact cycling Japanese monkeys and 3 castrated ones: The former sacrificed in the early, late follicular phase, and mid luteal phase, and the latter 8 weeks after castration. All 13 pituitary glands were fractionated by isoelectrofocusing (IEF). The mid cycle peaks of estradiol (E2) and bioactive LH occurred simultaneously in 11 out of 13 monkeys. No animals showed luteal phase peaks in the plasma E2 concentration. Bioactive LH content (IU/mg wet weight) in the pituitary gland was significantly correlated with plasma E2 levels in the cycling monkeys (R2 = 0.974) and it was the highest in monkeys in the late follicular phase. Bioactive LH in the pituitary gland was separated into 6 distinct species in terms of pI values by IEF; A(9.31 +/- 0.19), B(8.88 +/- 0.17), C(8.36 +/- 0.17), D(7.92 +/- 0.18), E(7.32 +/- 0.16) and F(acidic LH). Among alkaline LH species, the most predominant ones were Fractions B, C and D in the early follicular phase, Fraction A followed by B in the late follicular phase and Fraction B followed by C in the mid luteal phase. The neutral and acidic LH (Fraction E and F) was increased more in the early follicular phase and in the castrates. In conclusion, LH species separated by IEF may correspond to the stage of molecular maturation of pituitary LH.(ABSTRACT TRUNCATED AT 250 WORDS)     

Invasive testing for the karyotyping of mid-trimester intrauterine fetal death (IUFD): a pilot study

INTRODUCTION: Aneuploidy remains a common cause of fetal loss after the first trimester. Conventional karyotyping from fetal solid tissues post-delivery unfortunately has a poor success rate particularly where the fetus is macerated. To overcome this we obtained amniocentesis and/or chorionic villus samples from mid-trimester intrauterine fetal deaths (IUFDs) prior to medical termination of pregnancy. SUBJECTS: Ten women with diagnosed IUFD between 12 and 24 weeks' gestation underwent amniocentesis and/or CVS performed after counselling. RESULTS: Successful karyotypes were obtained in all pregnancies. Five of the ten pregnancies were complicated by aneuploidy (two with trisomy 21, two with trisomy 18, and one with trisomy 13). CONCLUSION: The high rate of aneuploidy (50%) in this small cohort emphasises the need for karyotyping. A successful karyotype in all ten pregnancies demonstrates the value of offering these procedures before a termination of pregnancy. We would recommend the adoption of this approach in the management of IUFD occurring after the first trimester.     

dl—15-甲基前列腺素F_(2α)合并丙酸睾丸酮抗早孕的临床研究新进展(Ⅱ)

本研究在前一阶段工作的基础上,进一步缩短了15-甲PGF_(2α)疗程和减少用药量,并以β-hCG放射免疫测定为主要指标,观察抗早孕效应。停经49天以内的60例早孕妇女随机分为两组,每组30例。组Ⅰ的15-甲PGF_(2α)最高用量为10毫克,组Ⅱ为8毫克;两组用药疗程均为8小时(比以前缩短4小时)。丙酸睾丸酮用法同前。结果两组抗早孕有效率分别为96.67%和100%(p>0.05);15-甲PGF_(2α)平均用量分别为9.67±0.21和7.70±0.19毫克(p<0.05)。组Ⅱ用药比组Ⅰ少2毫克,更适于门诊推广应用。本文并对β-hCG放射免疫测定在药物抗早孕研究中的应用及丙酸睾丸酮的抗早孕机理进行了讨论。