epimestrol and Anovulation

There are many methods that can be used to induce ovulation when there is a fault in ovulation in patients who have normal prolactin levels. These are: Bringing the weight to a normal level. Giving Clomiphene. Giving Tamoxifen. Giving cyclofenil and bromocriptine, which really have no more effect than giving a placebo. Giving gonadotrophins in a classical way. This is very useful where there is hypogonadic amenorrhoea but much less useful when the failure of ovulation occurs with normal gonadic function. It is accompanied by a risk of multiple pregnancies and of hyperstimulation, which should be monitored by ultrasound very strictly so that it cannot become too serious. The use of purified FSH which theoretically should be more adequate, at least in cases where the gonadic function is normal in spite of failure of ovulation. Pulsatile administration of LHRH, which in cases of hypothalamic amenorrhoea carries less total risk than giving gonadotrophins. Finally, wedge resection of the ovaries which is reversed for polycystic ovaries that are larger than normal in size, and allied methods. The first choice for hypogonadic hypothalamic amenorrhoea would seem to be the LHRH pump; and for failure of ovulation with normal gonadic function Clomiphene or Tamoxifen. When anti-oestrogens fail to correct these latter cases one can choose according to the case between gonadotrophins, choosing if possible pure FSH, and/or wedge resection. In the last resort in these cases the LHRH pump can be used. The frequent failure of these methods show that perhaps it is possible to create a hypogonadotrophic hypogonadism by giving agonists for a long time or antagonists to LHRH in such a way that a second attempt can be made to induce ovulation using gonadotrophins in better conditions of efficacy and safety.

Topics: Amenorrhea; Anovulation; Clomiphene; Cyclofenil; Epimestrol; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Hypogonadism; Hypopituitarism; Hypothalamic Diseases; Menotropins; Obesity; Ovary; Ovulation Induction; Tamoxifen; Thinness

Topics: Adult; Anovulation; Clinical Trials as Topic; Epimestrol; Estrenes; Female; Fertility Agents, Female; Follow-Up Studies; Humans; Infertility, Female; World Health Organization

In a gynaecological practice 49 patients were treated for primary or secondary infertility with epimestrol between January 1977 and June 1979. The selected group all had normogonadotropic, normoprolactinaemic anovulatory cycles (group II of the WHO scientific group 1976). Therapeutic measures extended over a total of 176 cycles in which 5 mg epimestrol (1 tablet Stimovul) were prescribed from the 5th to the 14th day. This procedure led to at least one ovulation in 86% of the cases and to pregnancy in 30 of the women. 23 pregnancies were without major complications. The abortion rate was 23%. Side effects of epimestrol treatment were only seen in occasional cases and only at the beginning of treatment.

Topics: Abortion, Spontaneous; Anovulation; Epimestrol; Estrenes; Female; Germany, West; Humans; Infertility, Female; Pregnancy

Topics: Anovulation; Chorionic Gonadotropin; Clomiphene; Cyclofenil; Drug Evaluation; Drug Therapy, Combination; Epimestrol; Estrogens; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Menotropins; Monitoring, Physiologic; Ovulation Induction; Pituitary Hormone-Releasing Hormones; Pregnancy; Progesterone; Prolactin

Report on the treatment of 310 anovulatory woment in 1173 treatment cycles with Clomiphen, Cyclofenil and Epimestrol. 63% of the patients had a biphasic basal body temperature record after treatment in 718 cycles. Patients with secondary amenorrhea of the first or the second degree had a satisfactory ovulation rate in 71% of the cases only by treatment with Clomiphen. In women with anovulatory cycles an overall ovulation rate of 75% was observed with all three medications. In 73 patients 78 pregnancies occurred. Of these, 38 pregnancies followed Cyclofenil, 25 pregnancies followed Clomiphen and 15 pregnancies followed Epimestrol corresponding to a 15%, 17% and 13% rate in the treated patients. 22 of these pregnancies ended in incomplete abortion. The side effects of Clomiphen especially visual and cystic ovarian and vasomotor side effects are more pronounced than the side effects of Cyclofenil and Epimestrol. The statistical analysis of the clinical results showed that Clomiphen and Cyclofenil had a higher rate of ovulation in secondary amenorrhea of the first or second degree than Epimestrol.

Topics: Amenorrhea; Anovulation; Body Temperature; Clomiphene; Cresols; Cyclofenil; Epimestrol; Estrenes; Female; Humans; Pregnancy; Vision Disorders

155 patients have been treated with epimestrol during 593 menstrual cycles in a daily dosage of 5, 10 or 2.5 mg from the 1st to the 10th or from the 5th to the 14th day of the cycle. 143 patients with secondary amenorrhoea, anovulatory cycles, ovulatory oligomenorrhoea, corpus luteum insufficiency, and normal cycles received epimestrol after an average period of 2.4 years of involuntary infertility. The pregnancy rate was 21% (n = 30), the spontaneous abortion rate 13% (n = 4). Twelve further patients not seeking pregnancy were treated with epimestrol because of secondary amenorrhoea and (or) anovulatory bleeding. The results were as follows: 1) In eugonadotropic secondary amenorrhoea 8 out of 12 patients ovulated, 5 out of 10 patients wanting children became pregnant. No patient with hypogonadotropism ovulated. 2) Out of 25 patients with anovulatory cycles or bleeding 13 ovulated and 4 became pregnant. 3) 17 out of 68 oligomenorrhoeic patients became pregnant. 4) In 12 out of 24 patients with corpus luteum insufficiency the hyperthermic phase improved and four patients became pregnant. 5) In 12 patients without anomalous cycles these remained unchanged and there were no pregnancies. 6) No side effects could be observed.. 155 women (593 cycles) were treated for sterility with daily doses of 5, 10, or 2.5 mg of epimestrol, from the 1st to the 10th or from the 5th to the 14th day of the cycle. 143 of these patients suffered from secondary amenorrhea, anovulatory cycles, ovulatory oligomenorrhea, corpus luteal insufficiency, and even normal cycles, which resulted in an average of 2.4 years of involuntary sterility. The pregnancy rate was 21% (n = 30) and the rate of spontaneous abortion 13% (n = 4). 12 other women were treated with epimestrol because of secondary amenorrhea or anovulatory bleeding. In those patients with eugonadotropic secondary amenorrhea, 8 of 12 ovulated and 5 of 10 desiring children became pregnant. No patients with hypogonadotropism ovulated. Of 25 patients with anovulatory cycles or bleeding, 13 ovulated and 4 became pregnant. Of those with oligomenorrhea, 17 out of 68 became pregnant. 12 out of 24 patients with corpus luteal insufficiency showed in improvement in the hyperthermic phase and 4 became pregnant. 12 patients with normal cycles showed no change and did not become pregnant. No side effects were experienced.

Topics: Abortion, Spontaneous; Amenorrhea; Anovulation; Berlin; Epimestrol; Estrenes; Female; Humans; Infertility, Female; Oligomenorrhea; Pregnancy; Time Factors

Topics: Anovulation; Epimestrol; Estrenes; Estrogens; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Ovulation; Pregnancy

Topics: Amenorrhea; Anovulation; Epimestrol; Estrenes; Female; Humans; Ovulation; Pregnancy