menotropins and Body-Weight

A simple scheme of investigation and treatment to restore fertility in amenorrhoeic women is described. Fifty-nine patients with amenorrhoea not due to primary ovarian failure were treated variously as appropriate, mainly with clomiphene (25), bromocriptine (15), or human menopausal gonadotrophins (12), and six by diet to increase their weight. All ovulated, and by the end of the study 55 (93%) had conceived, 42 (71%) had delivered at least one surviving child, and five others (8%) were pregnant and awaiting delivery. Conception rates were 49% within two cycles of treatment and 66% within three cycles; using life-table method to standardise the cumulative conception rates by correcting for patients who did not continue as long as others in the study, the expected conception rate was 79% in six cycles, 94% in 12 cycles, and 98% after 16 cycles. The multiple pregnancy rate was 13% and abortion rate 22%. Delivery rate (for a viable baby) were 48% within 11 months of starting treatment and 53% within one year; expected rates were 76% in 18 months and 97% in two years. The results show that a relatively simple scheme of classifying amenorrhoeic disorders endocrinologically followed by treatment directed at inducing ovulation allows amenorrhoeic women without primary ovarian failure to achieve conception and delivery rates equal to those in normal women.

Topics: Adult; Amenorrhea; Body Weight; Bromocriptine; Clomiphene; Female; Fertility; Fertility Agents, Female; Fertilization; Humans; Menotropins; Ovulation Induction; Pregnancy; Pregnancy, Multiple; Time Factors

Our purpose was to determine whether aortic size and compliance are altered by an exogenously induced rise in estrogen.. Magnetic resonance imaging was used to determine the aortic cross-sectional area/aortic pressure relationship in nine premenopausal women before and after menotropin therapy. Simultaneous electrocardiograms, carotid pulse tracings, phonocardiograms, and brachial artery pressures were obtained before each magnetic resonance imaging acquisition. Ascending thoracic aorta cross-sectional area was obtained every 32 msec and aligned with brachial artery pressures extrapolated from the carotid pulse tracing, allowing construction of the ascending thoracic aorta cross-sectional area/aortic pressure relationships. Aortic cross-sectional area was normalized to body surface area, and the shifts in the position for the ascending thoracic aorta cross-sectional area/aortic pressure relationship were determined with use of analysis of covariance.. Heart rate and aortic pressure were unchanged before and after menotropin treatment. Initial estradiol levels were < 20 pg/ml. After menotropin treatment (7.4 +/- 1.0 days) estradiol levels rose to 905 +/- 371 pg/ml (p < 0.0001). Ascending thoracic aorta cross-sectional area/body surface area was not significantly increased, adjusted y mean of 389 +/- 7 mm2/m2 before and 403 +/- 7 mm2/m2 after menotropin treatment (p < 0.24). The slope of the ascending aorta cross-sectional area/aortic pressure relationship, an index of aortic compliance, increased from 1.4 +/- 0.6 mm2/m2/mm Hg before to 1.7 +/- 0.6 mm2/m2/mm Hg after menotropin treatment (p < 0.001).. In premenopausal women a short-term rise in estrogen induced by menotropin treatment is associated with an increase in aortic compliance. Aorta size is not significantly increased within this time frame.

Topics: Adult; Analysis of Variance; Aorta, Thoracic; Blood Pressure; Body Weight; Compliance; Estrogens; Female; Heart Rate; Humans; Linear Models; Magnetic Resonance Imaging; Menotropins; Middle Aged; Premenopause; Vascular Resistance

The applications of exogenous hormones in different species for the induction of oocyte production, final oocyte maturation (FOM), and spawning for their reproduction is getting more attention day by day. The current preliminary research work was carried out to induce breeding in Clarias gariepinus, commonly known as African catfish, imported from Thailand. Single doses of two hormones as Ovaprim and human menopausal gonadotropin (hMG) were used and the research work was carried out at Muzaffargarh Fish Hatchery Punjab, Pakistan. A total of twenty-four (n = 24) C. gariepinus were selected having body weight approximately 2 kg and divided into two main groups based on gender as male (n = 12) and female (n = 12). For milt collection, all males were treated with Ovaprim 0.5 mg/kg body weight (b.w.) and female fish were divided into three groups as A, B, and C with four (n = 4) fish in each group. Group A was injected with only normal saline (control group) while fish in group B and group C were treated with hMG at 0.5 mg/kg b.w. and Ovaprim 0.5 mg/kg b.w., respectively. Then, after 6 h of hormone injections until 48 h, spawned eggs, eggs' weight, fertilization rate, hatching rate, survival rate, fecundity, and deformed larvae were investigated. The results revealed that Ovaprim injection significantly (p < 0.05) modulate the reproductive parameters in group C while no breeding was induced in both control and hMG-treated groups. Hence, it could be concluded that Ovaprim has the potential to induce breeding in African catfish, while in the current study, hMG failed to induce breeding. However, trials at large scales are required to further explore the effect of different doses of both tested hormones by increasing the treated subjects particularly in Pakistani fish farms.

Topics: Animals; Body Weight; Breeding; Catfishes; Domperidone; Drug Combinations; Female; Gonadotropin-Releasing Hormone; Male; Menotropins

The question of whether adjustment to body weight is necessary in in-vitro fertilization (IVF) cycles using GnRH antagonists is currently under discussion. Therefore, a data analysis of five prospective studies using either the single- or the multiple-dose antagonist protocol with cetrorelix (Cetrotide) was performed. The influence of stimulation procedure, gonadotrophins and body weight on pregnancy rate was evaluated in a linear logit model. The effect of the stimulation procedure and body weight on the cumulus-oocyte complex (COC) and follicle number was explored in an ANOVA model. Cetrorelix plasma concentrations were tested for any correlation with body weight. Baseline and outcome parameters in different body weight groups (<50 kg, 50-59 kg, 60-69 kg, 70-79 kg, > or =80 kg) were assessed for human menopausal gonadotrophin and recombinant human FSH stimulation separately. Cetrorelix plasma concentrations were correlated with body weight, but no influence of the type of stimulation or body weight on pregnancy rate was found. Body weight did not influence cetrorelix plasma concentrations. In contrast, body weight significantly influenced the number of retrieved COC as well as the number of follicles on the day of human chorionic gonadotrophin administration. Body weight does not influence the outcome of treatment in cetrorelix cycles.

Topics: Body Weight; Cell Count; Female; Fertilization in Vitro; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Hormone Antagonists; Humans; Linear Models; Menotropins; Oocytes; Osmolar Concentration; Ovarian Follicle; Ovulation Induction; Pregnancy; Pregnancy Rate; Retrospective Studies; Tissue and Organ Harvesting; Treatment Outcome

To assess serum leptin levels based on body habitus and ovarian morphology during controlled ovarian hyperstimulation.. Prospective analysis.. University IVF program.. Women undergoing IVF-ET were divided into two groups, obese ovulatory women (n = 6; mean (+/-SD) body mass index, 30.1 +/- 0.6 kg/m(2)) and lean ovulatory women (n = 20); mean (+/- SD) body mass index 22.0 +/- 0.2 kg/m(2)). Lean women were categorized further according to whether they had polycystic-appearing ovaries (n = 8) or normal-appearing ovaries (n = 12).. Controlled ovarian hyperstimulation and IVF.. Serum estradiol, testosterone, and leptin.. Mean (+/- SD) leptin levels were significantly higher before and after GnRH agonist down-regulation in obese women (41.7 +/- 5.2 pg/mL and 36.1 +/- 5.8 pg/mL, respectively) compared with lean women (8.4 +/- 1.0 pg/mL and 6.9 +/- 1.1 pg/mL, respectively). Mean (+/- SD) leptin levels increased significantly in both groups (54.5 +/- 5.1 pg/mL and 11.7 +/- 1.2 pg/mL, respectively), and the mean (+/-SD) percentage increase was similar (55% +/- 18% and 54.8% +/- 17%, respectively). Mean (+/-SD) leptin levels were similar in women with polycystic-appearing and normal-appearing ovaries before controlled ovarian hyperstimulation, but increased significantly in women with polycystic-appearing ovaries afterward (14.7 +/- 1.8 pg/mL and 9.3 +/- 1.0 pg/mL, respectively).. Significant increases in leptin levels occur during controlled ovarian hyperstimulation, suggesting that leptin plays a role in follicular growth and maturation. The exaggerated response in women with polycystic-appearing ovaries reflects either a greater number of recruited follicles or a predisposition of adipocytes to leptin production.

Topics: Adult; Body Weight; Case-Control Studies; Estradiol; Female; Gonadotropin-Releasing Hormone; Humans; Infertility, Female; Leptin; Menotropins; Obesity; Ovary; Ovulation Induction; Polycystic Ovary Syndrome; Prospective Studies; Testosterone

The role of intravenous immunoglobulin (IVIG) in the prevention of severe ovarian hyperstimulation syndrome (OHSS) was evaluated.. Ovarian hyperstimulation was induced in eight rabbits using human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG) after pretreatment with IVIG (IVIG group) or bovine serum albumin (BSA group). Main outcome measures included (1) signs of OHSS, such as the degree of ascites formation and the increase in body weight; and (2) the degree of ovarian stimulation as reflected by serum sex-steroid hormone levels.. A significantly lower ascites response and a tendency toward a decreased change in body weight were observed in the IVIG group compared to the BSA group. Serum estradiol, progesterone, total protein, and ovarian weights were not statistically different between the two groups.. IVIG prevented severe OHSS in a rabbit model, whereas BSA did not. Further studies are justified in an attempt to clarify the role of the immune system and IVIG in the pathophysiology and prevention of severe OHSS.

Topics: Animals; Ascites; Ascitic Fluid; Blood Proteins; Body Weight; Chorionic Gonadotropin; Cytokines; Estradiol; Female; Immunoglobulins; Menotropins; Ovarian Hyperstimulation Syndrome; Progesterone; Rabbits

We investigated the possible effects of the angiotensin converting enzyme (ACE) inhibitor cilazapril and angiotensin II antagonist saralasin on ovulation, ovarian steroidogenesis and ascites formation in the ovarian hyperstimulation syndrome (OHSS) in the rabbit model. OHSS was induced in rabbits by human menopausal gonadotropin (hMG) and intermittent human chorionic gonadotropin (hCG). In the cilazapril group (n = 10), animals also received cilazapril 2 mg/kg intraperitoneally daily for 7 days. In the saralasin group (n = 8), animals received saralasin intraperitoneally 1 h before or 1 h after hCG administration. Control animals (n = 8), received intraperitoneal saline solution. Serial blood samples were drawn on days 1, 5, 7 and 9 to measure serum estradiol and progesterone levels. On day 9, all rabbits underwent surgical exploration. Peritoneal and pleural fluid formation, ovarian weights and number of ovulations were determined. The volume of the ascitic and pleural fluids after hyperstimulation were not statistically different between the control, cilazapril and saralasin groups. The weight gains and ovarian weights of animals were similar between treatment and control groups. Saralasin significantly (p < 0.05) inhibited ovulation, but cilazapril did not. Cilazapril and saralasin did not affect progesterone production. Only cilazapril significantly decreased estradiol production (p < 0.05). In conclusion, the ACE inhibitor cilazapril and angiotensin II antagonist saralasin did not prevent ascites formation in OHSS. The ovarian renin-angiotensin system may not be the only factor acting in ascites formation in the OHSS.

Topics: Angiotensin II; Angiotensin-Converting Enzyme Inhibitors; Animals; Ascitic Fluid; Body Weight; Chorionic Gonadotropin; Cilazapril; Estradiol; Female; Menotropins; Ovarian Hyperstimulation Syndrome; Ovulation; Progesterone; Rabbits; Saralasin

The testis is a common site of relapse in childhood acute lymphoblastic leukaemia (ALL). In adults, testicular relapses of ALL are very rare. A similar age-difference in the frequency of the testicular infiltration exists also in the rat T-cell leukaemia. In the present investigation, the effect of various hormonal treatments and unilateral cryptorchidism on the form of testicular infiltrates by the rat T-cell leukaemia was studied. Inhibition of testicular activity by estradiol treatment (E2) of early pubertal rats injected i.p. with rat T-leukaemic lymphoblasts significantly decreased the proportion of the testis occupied by leukaemic infiltrates. The proportion of the testis occupied by leukaemic infiltrates was significantly higher in the abdominal testes of both early and late pubertal unilaterally cryptorchid rats, than in the scrotal testes of leukaemic control rats. Daily treatment of early pubertal rats with human chorionic gonadotrophin (hCG), or human menopausal gonadotrophin (hMG), did not have an effect on testicular leukaemic infiltration. These studies demonstrate that the leukaemic infiltration of the testis is influenced by the changes in the physiological activity of the testes.

Topics: Animals; Body Weight; Chorionic Gonadotropin; Cryptorchidism; Estradiol; Leukemic Infiltration; Male; Menotropins; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Puberty, Precocious; Rats; Testis; Testosterone; Tumor Cells, Cultured

A total of 111 women with no ultrasonographic findings of polycystic ovarian syndrome were observed between January 1989 and December 1991 in an in-vitro fertilization (IVF) programme. The treatment schedule involved ovulation induction after treatment with a gonadotrophin-releasing hormone (GnRH) agonist, using standard doses of human menopausal gonadotrophin (HMG) for 4 days, and further stepwise increments in dosage as required. Response to the treatment was defined as: (i) presence/absence of one or more follicles > or = 10 mm diameter after 4 days of treatment, and (ii) oocyte retrieval. Three indices of body mass were considered: weight (W) in kg/height (H)2 in metres (Quetelet's index), W/H1.5 (the National Health and Nutrition Examination Survey anthropometric index for women), W0.30/H (ponderal index). Surface area was computed as 0.0235 (H in cm0.422) (W in kg0.515). Women in the upper tertiles of the range of anthropometric indicators more frequently tended to present no follicle > or = 10 mm on day 7. Likewise, oocytes were retrieved less frequently in subjects in the higher tertile than in those in the lower. The odds ratio of a negative response both on day 7 and at the end of treatment increased with the tertiles of body mass indices or surface areas. This study suggests that response to ovulation induction treatment is inversely related to body mass index.

Topics: Adult; Body Height; Body Mass Index; Body Surface Area; Body Weight; Female; Fertilization in Vitro; Humans; Menotropins; Ovulation Induction; Pregnancy

Whereas the dose of hMG is significantly correlated with both BMI and BW, commencing the more obese patient on higher hMG doses is not justified in view of the cancellation of cycles from over-responsiveness in the more obese patients started on higher hMG dosage regimens. If the more obese patient is slow to respond, however, a greater degree of clinical freedom may be exercised to increase the dose. The ultimate outcome of the cycle is not related to BMI, BW, or the dose of hMG used.

Topics: Aging; Body Mass Index; Body Weight; Female; Humans; Menotropins; Ovulation Induction; Polycystic Ovary Syndrome; Pregnancy

A retrospective analysis was performed of 368 normally cycling women treated with a single cycle of a standard ovarian hyperstimulation regime (CC 100 mg days 5 to 9 and hMG 150 IU days 6, 8, and 10) associated with either an IVF or GIFT program. Neither the peak serum E2 level attained nor the number of days of stimulation required bore a relationship to the BMI or the total body weight of these women. Whereas the mean number of oocytes aspirated from women with BMI less than 19.1 was higher (6.4 +/- 3.2) compared with obese women (BMI greater than 27.6, 4.8 +/- 2.6), the rate of fertilization was not different for both BMI extremes. It is concluded that factors other than BMI or total body weight have more important influences on the response to hyperstimulation in normal women.

Topics: Body Mass Index; Body Weight; Clomiphene; Estradiol; Female; Humans; Menotropins; Ovulation Induction; Retrospective Studies

Twenty-four women with luteal phase defects who were ovulatory on clomiphene therapy with or without human chorionic gonadotropin (hCG) at midcycle for three to eight cycles yet failed to produce a live birth were treated with a short course of menotropin (hMG-S), one to two ampules for five days in the early follicular phase followed or not followed by hCG at midcycle for three to eight cycles. The luteal phase defect was diagnosed with repeat endometrial biopsies with a lag time of three or more days prior to clomiphene therapy. A complete infertility workup revealed only eight patients (33%) with a purely endocrine factor (luteal phase defect). The rest (16 patients, or 67%) had one or two additional infertility factors. Two abortions occurred in this group during clomiphene therapy, while five pregnancies (four live births and one spontaneous abortion) occurred during hMG-S therapy. The ovulation rates were similar for hMG-S (89%) and clomiphene (91%) therapy, but the frequency of a normal ovulatory cycle was significantly greater (P = .026) for hMG-S therapy (71%) than for clomiphene therapy (57%). The midluteal mean serum progesterone level was lower and the mean luteal length shorter in the cycles with less than 130 ng/mL/d of total integrated luteal progesterone. The postcoital test results showed better cervical mucus, with increased mucus volume and better fluidity and spinnbarkeit, in hMG-S cycles than in clomiphene cycles. It appears that hMG-S treatment can improve ovarian function and achieve successful pregnancy in patients with luteal phase defects who fail to produce a live birth during clomiphene treatment.

Topics: Adult; Body Weight; Cervix Mucus; Clomiphene; Female; Humans; Infertility, Female; Luteal Phase; Menotropins

Since previous data suggested hyperresponsiveness to human menopausal gonadotropin by women with low body weight, the daily dose was reduced to 1.5 ampules in patients undergoing in vitro fertilization weighing less than 55 kg. This allowed the extension of treatment to a minimum of 6 days. These changes were associated with improved results in in vitro fertilization in these women.

Topics: Body Weight; Estradiol; Female; Fertilization in Vitro; Humans; Menotropins; Ovulation Induction; Pregnancy; Prospective Studies

Dwarf mice show delayed testicular growth and their adult testis weights are half the normal value. The aims of the present work were firstly, to compare the developmental profiles of plasma gonadotropins and of testicular cell multiplication and differentiation in dwarf vs normal mice and secondly, to determine the effect of hMG supplementation on dwarf mice. In the dwarf mice no pubertal rise in plasma FSH was observed, and the adult values remained very low when compared with those of normal mice; plasma LH decreased after 40 days of age and remained equal to half the normal values. In adults, testicular testosterone content was greatly increased in dwarf mice compared with normal mice, whereas plasma testosterone and accessory gland weights were reduced. At 24 days of age, the total numbers per testis of Leydig and Sertoli cells were reduced in dwarf vs normal mice, whereas in adult mice their differentiation, but not their total numbers, was reduced. This resulted in lower daily production of leptotene primary spermatocytes and of round spermatids in dwarf than in normal mice. hMG supplementation promoted Leydig and Sertoli cell multiplication, but did not produce full differentiation, resulting in increased daily production of round spermatids. In conclusion, in adult dwarf mice a deficiency in plasma gonadotropins prevents full differentiation of Leydig and Sertoli cells without affecting the number of these cells.

Topics: Animals; Body Weight; Cell Count; Follicle Stimulating Hormone; Leydig Cells; Luteinizing Hormone; Male; Menotropins; Mice; Mice, Inbred Strains; Organ Size; Seminiferous Tubules; Sexual Maturation; Spermatogenesis; Testis; Testosterone

Women who conceive with human gonadotropins have a high rate of spontaneous abortions. The causes for this poor outcome are unknown. In a retrospective analysis, the authors analyzed potential factors in 45 menotropin-treated patients with spontaneous first-trimester miscarriages. Data were compared with 119 menotropin-treated patients who conceived and delivered viable infants. Patient factors that were analyzed included the following: age, history of past miscarriages, duration of infertility, diagnostic category, weight, body surface area, duration and weight-corrected dose of menotropin administration, maximum estradiol level, estradiol pattern, human chorionic gonadotropin (hCG) dose, presence or absence of hCG support in the luteal phase, results of postcoital testing, methods of insemination, and results of husband's semen analysis. There was a significant difference between the miscarriage group and the control group in regard to age and weight distribution. All other characteristics were not significantly different. Patients over 81.8 kg as well as patients aged 35 years and older were both significantly (P less than 0.01) at increased risk to have a spontaneous first-trimester miscarriage. The data suggest that obesity and advanced age contribute to the high miscarriage rate in menotropin-treated patients. It appears reasonable to suggest that women weighing more than 81.8 kg should make every effort to lose weight before beginning menotropin therapy.

Topics: Abortion, Spontaneous; Adult; Age Factors; Body Weight; Chorionic Gonadotropin; Estradiol; Female; Humans; Infertility; Menotropins; Pregnancy; Retrospective Studies; Risk Factors

One hundred four normally cycling women were treated with fixed low-dose human menopausal gonadotropin (hMG) (2 ampules/day) in preparation for oocyte aspiration for in vitro fertilization. The response rate was related to age, weight, and the ratios weight/height2 and weight/height. The required dose of hMG was related to total body weight, but not to age or either of the weight/height ratios. In patients who required fewer than 5 days of hMG (rapid responders), a significantly higher number (P less than 0.02) of oocytes were harvested, compared with slow responders. However, a smaller percentage of the oocytes from rapid responders fertilized (P less than 0.003) and resulted in a reduced rate of embryo transfer. The difference in pregnancy rates was not statistically significant. The results of the study suggest that patients undergoing in vitro fertilization who weigh less than 55 kg may benefit from treatment with a lower dose of hMG to prolong the stimulation cycle.

Topics: Adult; Age Factors; Body Height; Body Weight; Female; Fertilization in Vitro; Humans; Infertility, Female; Menotropins; Ovulation Induction; Time Factors

Patients failing to ovulate and conceive on clomiphene citrate (CC) or CC plus human chorionic gonadotropin (hCG) or patients with pituitary gonadotropin deficiency are candidates for human menopausal gonadotropin (hMG) plus hCG therapy. The duration and number of ampules needed to stimulate ovarian response leading to ovulation and/or pregnancy vary individually. Seventy-one patients who had complete follow-up evaluation and accurately documented body weights at the time of therapy were considered for the study. Of these 71 patients, 41 (57.3%) conceived in 293 cycles. The average number of ampules of hMG used by patients with 10% to 20% below ideal body weight (IBW) was 13.9 +/- 6.3 (mean +/- standard deviation [SD]). The average number of ampules used by patients with normal +/- 10% IBW was 14.2 +/- 3.5. Patients who were overweight by 10% to 25% used 15.3 +/- 5.4 ampules, and patients overweight by greater than or equal to 25% used 20.9 +/- 5.6 ampules of hMG. Eleven patients with severe hypothalamic chronic anovulation needed an average of 20.6 +/- 6.2 ampules. The data reveal a direct relationship between IBW and the amount of hMG needed to induce ovulation and/or pregnancy; however, in the presence of chronic hypoestrogenic conditions, it is expected that these patients will need higher amounts of hMG, regardless of body weight.

Topics: Body Weight; Chorionic Gonadotropin; Female; Follow-Up Studies; Humans; Menotropins; Ovulation Induction; Pregnancy; Retrospective Studies

Topics: Adult; Amenorrhea; Body Weight; Chorionic Gonadotropin; Clomiphene; Contraceptives, Oral; Estradiol; Female; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Menotropins; Ovulation Induction; Pregnancy; Pregnancy, Multiple; Progesterone