Endometrial morphology and peripheral hormone levels in women with regular menstrual cycles

Endometrial biopsies from 90 women with regular menstrual cycles and a hormonal profile compatible with normal luteal function were morphometrically assessed using 11 different indices and the results were plotted in 48-hour periods around the day of the luteinizing hormone (LH) surge (LH +/- 0). The endometrial dating reached its highest significance from days LH -3/-2 to days LH +7/+8, when the changes occurred with a high degree of regularity regardless of the length of the preovulatory and postovulatory phases. It is proposed therefore that the dating of the endometrium should be related to the LH surge rather than to the "ideal" 28-day cycle. The results also seem to suggest the existence of a regulatory mechanism for the synchronization of follicular maturation and midcycle endometrial development. Further study of the factors involved in this mechanism may result in a better understanding of certain forms of unexplained infertility.     

Should androgen levels be measured in hirsute women with normal menstrual cycles?

In a study of 129 consecutively referred hirsute women, 40% had regular menstrual cycles. About one half of such individuals had elevated levels of one or more androgens (DHEAS, testosterone or free testosterone index), whereas a higher proportion (69%) of hirsute women with oligo-amenorrhea were abnormal. Mean androgen levels in regularly cycling hirsute women were higher than in controls, but lower than or equal to those in oligo-amenorrheic hirsutism. Thus, menstrual status does not predict androgen status in hirsute women.     

Plasma glucose and insulin levels during the menstrual cycles of normal women and premenstrual syndrome patients

Three-hour oral glucose tolerance tests were performed on days 5 and 25 of ovulatory menstrual cycles in 26 women. The women were divided into normal (n = 9) and premenstrual syndrome (PMS) (n = 17) categories. Ovulation was confirmed by basal body temperature records and plasma progesterone levels. There were no statistically significant changes in the plasma glucose or insulin levels between the two tests in either group. Except for a higher two-hour plasma insulin concentration on the day 5 test in normal women, no statistically significant carbohydrate differences were noted between the groups. The data suggest that alterations in carbohydrate metabolism are not important in PMS.     

Preovulatory serum gonadotropin levels in hMG stimulated menstrual cycles in pregnant and nonpregnant patients

In a group of patients undergoing in vitro fertilization, 10 pregnant and 10 nonpregnant, cycles were analysed in retrospect in relation to gonadotropin and steroid hormones. All patients were similar in terms of age, body surface area and initial stimulation protocol. The increase in follicles stimulating hormone (FSH) was significantly higher in the pregnant group through cycle day 8 as compared with cycle day 3 before stimulation. A significant increase in the nonpregnant group was never detectable; the mean FSH levels rather decreased to the baseline value during stimulation after a slight nonsignificant increase. The levels of luteinizing hormone (LH) decreased significantly in pregnant and nonpregnant patients during stimulation. No significant difference in the FSH/LH ratio between the pregnant and nonpregnant group was encountered. Although the mean serum estrogen in the follicular phase and the serum estrogen and progesteron values in the luteal phase were higher in the pregnant patients, no statistically significant difference between groups could be demonstrated, until luteal day 11. It is believed from this study, that a 15-20% increase in serum FSH levels over baseline during the early and mid follicular phase is required for adequate follicular development and steroidogenesis. The determination of serum gonadotropins in the follicular phase in patients who failed to conceive, might reveal differences, which can account for failures in hMG induced cycles.     

Serum gonadotrophin and sex steroid hormone levels during mid-follicular and mid-luteal phases in hyperprolactinaemic women with regular menstrual cycles

Summary. Hyperprolactinaemia was found in 15 of 135 infertile patients with regular menstrual cycles, biphasic basal body temperature record and no galactorrhoea. In those 15 women, mean serum prolactin levels during the mid-follicular and mid-luteal phases of the menstrual cycle were 29.8 (SEM 1.8) ng/ml and 29–5 (SEM 1.3) ng/ml, respectively. Although serum FSH and LH levels were similar in normal and hyperprolactinaemic women, serum oestradiol level during the mid-follicular phase was subnormal in hyperprolactinaemic women ( P <0.05). In contrast, serum oestradiol and progesterone levels during the mid-luteal phase and luteal phase length were similar in nor-moprolactinaemic and hyperprolactinaemic groups. The results suggest that Hyperprolactinaemia is associated with defects of follicle development as measured by oestradiol production during the mid-follicular phase, but not with corpus luteum function as measured by progesterone production during the mid-luteal phase, and luteal phase length.     

Serum gonadotrophin and sex steroid hormone levels during mid-follicular and mid-luteal phases in hyperprolactinaemic women with regular menstrual cycles

Hyperprolactinaemia was found in 15 of 135 infertile patients with regular menstrual cycles, biphasic basal body temperature record and no galactorrhoea. In those 15 women, mean serum prolactin levels during the mid-follicular and mid-luteal phases of the menstrual cycle were 29.8 (SEM 1.8) ng/ml and 29.5 (SEM 1.3) ng/ml, respectively. Although serum FSH and LH levels were similar in normal and hyperprolactinaemic women, serum oestradiol level during the mid-follicular phase was subnormal in hyperprolactinaemic women (P less than 0.05). In contrast, serum oestradiol and progesterone levels during the mid-luteal phase and luteal phase length were similar in normoprolactinaemic and hyperprolactinaemic groups. The results suggest that hyperprolactinaemia is associated with defects of follicle development as measured by oestradiol production during the mid-follicular phase, but not with corpus luteum function as measured by progesterone production during the mid-luteal phase, and luteal phase length.     

Analysis of gonadotropin pulsatility in hirsute women with normal menstrual cycles and in women with polycystic ovary syndrome

OBJECTIVE: To study the relation between plasma gonadotropin pulsatility, androgen levels, and estrogen levels in patients with polycystic ovary syndrome (PCOS), in hirsute women with normal menstrual cycles, and in healthy women. DESIGN: Prospective study. SETTING: University medical center-based cellular and molecular endocrinology laboratory. PATIENT(S): Eight healthy women (group 1), 9 hirsute women with normal menstrual cycles (group 2), and 19 women with PCOS (group 3). INTERVENTION(S): Plasma concentrations of LH and FSH were measured by RIA every 15 minutes for 12 hours. Main Outcome Measure(s): Rhythmic parameters of 12-hour LH and FSH secretion. RESULT(S): Rhythmic parameters of 12-hour LH secretion were significantly higher in patients with PCOS (group 3) than in controls (group 1) or in hirsute women with normal menstrual cycles (group 2). The frequency of LH pulses was statistically higher in patients with PCOS (group 3) than in controls (group 1). Statistically significant correlations were found when the frequency of LH pulses was plotted against basal LH concentrations and rhythmic parameters of 12-hour LH secretion. CONCLUSION(S): Luteinizing hormone pulse amplitude was higher in patients with PCOS than in hirsute women with normal menstrual cycles or in healthy women. The LH pulse frequency was increased only in patients with PCOS compared with healthy women and not in hirsute women with normal menstrual cycles.     

Effects of chronic sulpiride-induced hyperprolactinemia on menstrual cycles of normal women

We investigated the influence of chronic (27-65 days) sulpiride-induced hyperprolactinemia on the menstrual cycles of four normal women. The hyperprolactinemia (206.4 ng/mL, the average of the mean values of each subject obtained by sulpiride treatment) suppressed the LH surge and the secretion of plasma estradiol-17 beta and progesterone to their basal levels. The results suggest that the endocrine changes in normal women with sulpiride-induced hyperprolactinemia are similar to those in women with spontaneous hyperprolactinemia. Sulpiride-induced hyperprolactinemia may be useful as a model for studying spontaneous hyperprolactinemia.     

Premenstrual increase of intracellular magnesium levels in women with ovulatory,asymptomatic menstrual cycles

For arginine-vasopressin (AVP) it has been suggested that about 90% of the total amount present in peripheral blood is platelet-membrane bound.

Oxytocin (OT) and AVP are nonapeptides which are similar in many respects. We investigated the possibility that OT might be found in platelet-rich plasma samples from patients undergoing ovarian super- stimulation for in-vitro fertilization purposes. These plasma samples were treated with acid repeated freezing/thawing and sonification in an attempt to solubilize or expose the possible bound OT. No differences between OT concentrations in platelet-rich or -poor plasma samples were found.

We conclude that plasma OT is not bound or confined to platelets.     

Modified hMG stimulated: an effective option in endometrial preparation for frozen-thawed embryo transfer in patients with normal menstrual cycles

To evaluate the clinical efficacy of modified human menopausal gonadotropin (hMG) stimulated, hormone replacement therapy (HRT), natural cycling and letrozole ovulation induction during endometrial preparation for frozen-thawed embryo transfer (FET) in patients with normal menstrual cycles. This retrospective analysis included a total of 5070 cycles of patients with normal menstrual patterns who underwent FET between October 2009 and September 2015. The patients were divided into four groups according to the method of endometrial preparation for FET: 1838 cycles were natural, 1666 underwent HRT, 340 underwent letrozole ovulation induction and 1226 underwent modified hMG stimulated. Reproduction-related clinical outcomes in the four groups were compared. The clinical pregnancy rates and live birth rates of patients in the modified hMG stimulated group were significantly higher than that in the other groups p?p?>.05). Modified hMG stimulated resulted in a higher pregnancy rate compared to the other treatment groups. Therefore, modified hMG stimulated may be an effective option in endometrial preparation for FET in patients with normal menstrual cycles.     

Premenstrual increase of intracellular magnesium levels in women with ovulatory, asymptomatic menstrual cycles

Intracellular magnesium (Mg) levels regulate several enzymatic reactions and the hypoactivity of Mg has been involved in different pathological states. In addition to other factors, gonadal hormones, too, have been found to interfere in Mg balance. This study evaluates the changes in Mg in women throughout the normal menstrual cycle and those measured at weekly intervals in males. Magnesium and potassium (K) levels were measured in the plasma, red blood cells (RBC), lymphocytes (LC) and polymorphonucleated cells (PMN) of 11 normal menstruating women, in different periods of their menstrual cycle. Blood samples were collected every 4th day. According to the time and LH, progesterone and estradiol levels, they were classed as follicular (Foll), periovulatory (OV), luteal (Lut) or premenstrual (PM). The Menstrual Distress Questionnaire completed by the subjects revealed that no significant symptomatology was present. Four blood samples were also collected from 4 normal males, at weekly intervals. Mg and K were determined by atomic absorption spectrophotometry. LC and PMN were purified by centrifugation on a Ficoll discontinuous gradient. No differences were found in males versus females in the Mg or K contents in the different compartments. In the 4 periods tested, the K levels were constant, in both females and males. The same applies for Mg contents in males. In females, Mg contents, as well as the Mg/K ratio in LC and PMN, showed a significant increase in the premenstrual period compared with the other periods of the cycle. On the contrary, plasma and RBC Mg levels were constant throughout the cycle.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of the OvuSTICK urinary luteinizing hormone kit in normal and stimulated menstrual cycles

The rapid analysis of luteinizing hormone (LH) in urine would provide a useful clinical tool in the diagnosis and treatment of infertility in women. Urinary LH levels were measured in midday and evening specimens collected during 75 normal and stimulated menstrual cycles (55 women) using a rapid, visual, semiquantitative enzyme immunoassay dipstick test (OvuSTICK) and compared with basal body temperature (BBT) records, visualization of follicular collapse by daily ultrasonography, and serum hormone levels. In all 75 cycles studied, an LH surge (or its absence) in urine was associated with a biphasic (or monophasic) BBT record and/or serum progesterone. In addition, when serum and urine samples were obtained simultaneously, the day of the LH surge (or its absence) in the urine and serum correlated 100%. Discrepancies between ovulation as diagnosed by ultrasound and the LH surge in urine and/or serum in several patients suggested that individual factor(s) may affect the interpretation of ultrasound imaging. It appears that a simple, rapid, clinically reliable colorimetric method such as the OvuSTICK urinary LH test is an important parameter for predicting the time of ovulation.     

Tumor tissue CA125 in ovarian carcinoma patients with normal serum levels

A good correlation between elevated serum CA125 and its immunolocalization in ovarian tumor tissue has been reported. This study was undertaken in order to assess the presence of CA125 in tumor tissue obtained from ovarian carcinoma patients with normal serum levels. Eleven such ovarian carcinoma patients (nine of them serous) were identified. In seven the level was normal prior to the initial operation, and in four, prior to a positive second-look operation. Immunohistochemical staining of paraffin sections for CA125 was positive in seven of the tumor tissue samples. Tumor tissue of most ovarian carcinoma patients with a preoperative normal serum CA125 contains the antigen, but an undetermined mechanism prevents elevated serum levels.     

Peripheral hormone levels and the endometrial condition in postmenopausal women

Thirteen postmenopausal women with benign endometrial changes including proliferative, secretory and polypous endometrium, endometrial hyperplasia and atypia (group I) and 13 randomly selected age-matched controls with normal atrophic endometrium (group II) were studied with respect to serum levels of dehydroepiandrosterone (DHA) and its sulfate (DHAS), testosterone, total estrone, estradiol-17 beta, progesterone, FSH and prolactin. Serum levels of DHA, DHAS, testosterone and total estrone were significantly higher in group I than in group II; otherwise no significant differences were found. Mean values for body weight and for Broca's index, respectively, were almost identical in the two groups. It is speculated that the adrenal androgens may affect the endometrium in two ways, viz. via peripheral conversion to estrogens and/or via direct interaction with endometrial steroid receptors. The results give further support to the hypothesis of an association between adrenocortical hyperactivity and endometrial abnormalities including endometrial carcinoma.