menotropins and Ovarian-Neoplasms

Topics: Age Factors; Chromosome Deletion; Contraceptives, Oral, Hormonal; Endometriosis; Female; Gonadotropin-Releasing Hormone; Humans; Menotropins; Ovarian Neoplasms; Ovulation; Reproduction; Risk Factors; Talc

Due to the different pharmacological mode of action, GnRH-antagonists seem to open up new avenues to hormonal treatment in several indications. Although it may be still too early to speculate about the possible end of the era of GnRH-agonists, from what is known today, the advantages of GnRH-antagonists are most evident in our opinion. When the development of sustained delivery systems may continue and be completed, the antagonists will have a major potential within benign gynecological conditions and also in the treatment of malignancies such as prostatic, mammary, endometrial or ovarian cancer. Suitable sustained delivery systems and the development of GnRH-antagonists with sufficient oral bioavailability, represent the present and future challenge for these efforts.

Topics: Clinical Trials, Phase III as Topic; Endometriosis; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Leiomyoma; Male; Menotropins; Neoplasms, Hormone-Dependent; Ovarian Neoplasms; Ovulation Induction; Pituitary Gland; Prostatic Neoplasms

Topics: Adrenal Cortex Hormones; Androgens; Animals; Clinical Trials as Topic; Drug Evaluation; Drug Therapy, Combination; Endometrial Hyperplasia; Estrogens; Female; Follicle Stimulating Hormone; Hormones; Humans; Hypothalamus; Menotropins; Ovarian Neoplasms; Ovary; Progesterone Congeners; Thiotepa; Thyroid Hormones

Topics: Adrenal Cortex Hormones; Androgens; Animals; Clinical Trials as Topic; Drug Evaluation; Drug Therapy, Combination; Endometrial Hyperplasia; Estrogens; Female; Follicle Stimulating Hormone; Hormones; Humans; Hypothalamus; Menotropins; Ovarian Neoplasms; Ovary; Progesterone Congeners; Thiotepa; Thyroid Hormones

Topics: Adenocarcinoma, Clear Cell; Adult; Clomiphene; Endometriosis; Female; Fertility Agents, Female; Humans; Hysterectomy; Infertility, Female; Menotropins; Neoplasm Staging; Ovarian Diseases; Ovarian Neoplasms; Ovariectomy; Ovulation Induction; Treatment Outcome

A 36 year-old infertile female developed a stage IV (FIGO) ovarian carcinoma consisting of a poorly differentiated Sertoli-Leydig cell tumour after receiving one course of ovulation induction with follicle stimulating hormone (FSH), human menopausal gonadotrophin (HMG) and human chorionic gonadotrophin (HCG) followed by gonadotrophin-releasing hormone analogue (GnRHa). The patient died of liver metastasis and hepatic failure 4 1/2 months after first diagnosis, despite aggressive treatment consisting of debulking surgery and aggressive adjuvant chemotherapy.

Topics: Adult; Chorionic Gonadotropin; Drug Therapy, Combination; Fatal Outcome; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Infertility, Female; Liver Failure; Liver Neoplasms; Menotropins; Ovarian Neoplasms; Ovulation Induction; Sertoli-Leydig Cell Tumor

To determine whether women with epithelial ovarian cancer are more likely to have been exposed to fertility drugs, and in particular hMG, than healthy population controls.. A nationwide case-control study.. Two hundred living women 36 to 64 years of age, with a histologically confirmed diagnosis of primary invasive or borderline epithelial ovarian cancer that was first diagnosed and reported to the Israel Cancer Registry between January 1, 1990 and September 1, 1993 were enrolled. There were 164 (82%) invasive and 36 (18%) borderline epithelial ovarian tumors among the 200 cases. The controls were 408 women from the same dialing areas selected by random digit dialing. Cases and controls were interviewed using a standard questionnaire. A multivariate logistic model was used to assess the association of fertility drug use and ovarian cancer, controlling for variables found to be statistically associated with this outcome on univariate analysis.. Twenty-four women with epithelial ovarian cancer (12%) and 29 healthy controls (7.1%) reported that they had used any fertility drug (adjusted odds ratio [OR] 1.31; 95% confidence interval [CI] 0.63 to 2.74). Among cases and controls, respectively, 22 and 24 reported that they had used hMG alone or in combination with clomiphene citrate (adjusted OR 1.42, 95% CI 0.65 to 3.12), and 11 and 6 reported that they had used hMG alone (adjusted OR 3.19, (95% CI 0.86 to 11.82). The risk was increased particularly in the subgroup of women with borderline ovarian tumors who had used hMG (adjusted OR 9.38, 95% CI 1.66 to 52.08).. We conclude that the use of ovulation induction agents, in particular hMG, may increase the risk of epithelial ovarian tumors.

Topics: Adult; Carcinoma; Case-Control Studies; Female; Fertility Agents, Female; Humans; Menotropins; Middle Aged; Ovarian Neoplasms

Hyperreactio luteinalis is a non-neoplastic tumor-like ovarian lesion associated with pregnancy. Most patients are asymptomatic, with the ovarian enlargement being incidentally discovered at the time of cesarean section. It can simulate a neoplasm on clinical, gross and sometimes microscopic examination. We report a case of hyperreactio luteinalis in a patient, who was diagnosed as having polycystic ovary disease before conceiving a triplet pregnancy after three treatment cycles of human menopausal gonadotropin-human chorionic gonadotropin therapy, and discuss its pathogenesis.

Topics: Adult; Chorionic Gonadotropin; Diagnosis, Differential; Drug Therapy, Combination; Female; Fertility Agents, Female; Humans; Menotropins; Ovarian Cysts; Ovarian Neoplasms; Polycystic Ovary Syndrome; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Triplets

Topics: Clomiphene; Female; Fertility Agents; Humans; Infertility; Menotropins; Neoplasms, Glandular and Epithelial; Ovarian Neoplasms; Retrospective Studies

Concerns have been raised recently about the possible association between superovulation and ovarian cancer. In order to contribute to the limited literature on this important issue, two cases of ovarian tumours in women who had undergone multiple ovulation inductions are presented. In the first case, the patient had secondary anovulatory infertility. She was treated with human menopausal gonadotrophin (HMG) alone and in combination with clomiphene citrate or buserelin for six cycles. She then underwent ovarian stimulation with buserelin/HMG in the long protocol for in-vitro fertilization (IVF) and embryo transfer. In preparation for a new IVF/embryo transfer attempt, 8 months later, the screening ultrasound revealed a cystic formation of the left ovary and an enlargement of the right. During laparotomy, both ovaries were found to bear large tumours (approximately 6 x 5 x 4 cm) which were removed. Histological examination showed that they were epithelial tumours (serous-papillary cystadenomas) of borderline malignancy. The patient conceived spontaneously 1.5 years after the operation. In the second case, the patient presented with secondary anovulatory infertility. She underwent ovulation induction with clomiphene/HMG and with buserelin/HMG in the long protocol, and intra-uterine insemination with husband's spermatozoa and conceived (singleton pregnancy). She was delivered by Caesarean section, during which a cystic tumour of the left ovary was removed. Histological examination revealed a benign mucous cystadenoma of the ovary.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Anovulation; Buserelin; Clomiphene; Cystadenoma, Mucinous; Cystadenoma, Papillary; Cystadenoma, Serous; Embryo Transfer; Female; Fertilization in Vitro; Humans; Infertility, Female; Menotropins; Ovarian Neoplasms; Ovulation Induction

Topics: Clomiphene; Female; Granulosa Cell Tumor; Humans; Menotropins; Ovarian Neoplasms; Ovulation Induction

Topics: Clomiphene; Female; Granulosa Cell Tumor; Humans; Menotropins; Ovarian Neoplasms; Ovulation Induction

We report 2 patients who developed a borderline malignancy of the ovary after treatment with follicular stimulants in the context of an in vitro fertilisation (IVF) programme. In both cases, conservative surgery for the borderline malignancy was sufficient treatment. Ultimately, both patients became pregnant, 1 after IVF treatment and 1 without treatment, and both delivered healthy babies. In addition to the presentation of both cases, the literature concerning the possible risks of treating patients with high dosage, exogenously administered hormones is reviewed and the possible association between exogenous hormones and the risk of developing ovarian cancer is discussed.

Topics: Adult; Chorionic Gonadotropin; Female; Fertilization in Vitro; Gonadotropin-Releasing Hormone; Humans; Menotropins; Ovarian Neoplasms; Ovulation Induction

Ovarian cysts are a common complication of GnRH-a administration. We followed 98 patients who were suppressed with GnRH-a before ovarian stimulation with hMG for IVF treatment. Approximately 20% of the patients receiving GnRH-a during the follicular or luteal phase had developed ovarian cysts. However, the number of cysts per patient was significantly higher in the follicular phase compared with luteal phase. Systematic aspiration of those cysts under local anesthesia permitted the start of ovarian stimulation with hMG as scheduled on day 16 after GnRH-a administration. Follicular fluid content of the cysts revealed similar levels of steroids to those in normal follicles. These cysts contained few cells and no egg. In vitro fertilization treatment was more successful in patients whose cysts were aspirated during the luteal phase than in those with cysts during the follicular phase. We concluded that luteal phase cysts are more benign than follicular phase cysts, and it is possible that they represent an enlargement of pre-existing corpora lutea.

Topics: Adult; Cysts; Estradiol; Female; Fertilization in Vitro; Follicular Phase; Gonadotropin-Releasing Hormone; Humans; Luteal Phase; Luteolytic Agents; Menotropins; Ovarian Neoplasms; Progesterone; Triptorelin Pamoate

To determine the effect of ovarian endometriomas on in vitro fertilization (IVF) outcome, two groups of patients were studied. Group I consisted of seven patients with ovarian endometriomas and severe pelvic adhesions treated for a total of 12 cycles. Group II patients consisted of eight patients with hydrosalpinges and comparable pelvic adhesions treated for a total of 27 cycles. There were no differences in the number of days required for stimulation or in the serum estradiol levels attained between the two groups. Group I patients were noted to have significantly fewer preovulatory follicles (1.42 vs 3.33, P less than 0.005), cycles with fertilization (28 vs 84%, P less than 0.005), and embryos transferred (0.78 vs 2.56, P = 0.01) than Group II patients. Three pregnancies occurred in Group II, while there were no conceptions among Group I patients. This study suggests that the presence of an ovarian endometrioma(s) has an adverse effect on IVF outcome and suggests that patients with ovarian endometriomas should have them removed prior to undergoing IVF.

Topics: Adult; Embryo Transfer; Endometriosis; Estradiol; Female; Fertilization; Fertilization in Vitro; Humans; Luteinizing Hormone; Menotropins; Ovarian Neoplasms; Ovulation; Pelvic Inflammatory Disease; Pregnancy; Pregnancy Outcome

A radioimmunoassay for the measurement of placental protein 5 (PP5) has been developed using a second antibody-polyethyleneglycol method to separate free from bound ligand. PP5 immunoreactivity was detected in culture media from a cell line derived from a small cell carcinoma of the ovary (SCCWm2). The culture-derived PP5 shares immunological identity with pregnancy and ovarian follicular PP5. Affinity interactions between PP5 and matrices such as heparin or thrombin-Sepharose were similar and independent of the origin of PP5. PP5 was heterogeneous with two forms, a monomer (18k) and dimer (36k) being detected in all biological fluids examined. The dimer was predominant in ovarian follicles and the SCCWm2 cell line, while the monomer predominated in pregnancy serum. The basal rate of PP5 secretion by the SCCWm2 cell line was 0.61AU/24h/10(5) cells. Incubation of cells in the presence of 150mIU Pergonal stimulated PP5 production 20.6 fold and following removal of Pergonal the production rate was maintained at 18.0 times the basal rate. No choriconic gonadotrophin, pregnancy-specific beta 1-glycoprotein, pregnancy associated plasma protein-A or alpha fetoprotein was detected in the culture medium of the SCCWm2 cell line.

Topics: alpha-Fetoproteins; Carcinoma, Small Cell; Cell Line; Chorionic Gonadotropin; Chromatography, Affinity; Culture Media; Female; Glycoproteins; Humans; Immunoelectrophoresis; Menotropins; Ovarian Follicle; Ovarian Neoplasms; Pregnancy; Pregnancy Proteins; Pregnancy-Associated Plasma Protein-A; Pregnancy-Specific beta 1-Glycoproteins; Radioimmunoassay

Various methods used by gynecologists in the past for hormone therapy and ovulation inducement are discussed including the administration of: 1) steroids composed mainly of estrogen, 2) clomiphene or tamoxifen (estrogen), 3) bromocriptine for high prolactin or latent (transitory) prolactin, 4) glucocorticoid for high androgen levels such as polycystic ovary or adrenogenital syndrome, 5) human menopausal gonadotropin (hMG) and human chorionic gonadotropin, and 6) hMG (pulsatile). In previous studies, another method--the administration of luteinizing hormone releasing hormone (LHRH) by drip infusion--was unsuccessful in inducing ovulation. However, experiments have been performed in which monkeys were given a pulsatile administration of LHRH every 60 minutes for 10-14 days. This new method proved successful in inducing ovulation and normalizing the ovulation cycle. Graphs showing the results of both the old method of ovulation inducement and the new method by pulsatile administration of LHRH are included. There is a brief discussion of contraception, examining, in particular, a new noncoital means of birth control involving antiprogesterone steroids which has been in the developmental stages for the past several years.

Topics: Adult; Anovulation; Contraceptives, Oral; Contraceptives, Oral, Hormonal; Estrenes; Female; Gestrinone; Gonadotropin-Releasing Hormone; Humans; Luteinizing Hormone; Menotropins; Mifepristone; Ovarian Cysts; Ovarian Neoplasms; Ovulation Induction

The endocrine profile of a 16-year-old girl with an androblastoma of the left ovary is presented. Calculated ratios of steroid hormones between the intraoperative peripheral vein blood, the left ovarian vein blood, and the left ovarian tumor fluid were progesterone, 1:10.2:39.5; 17-hydroxyprogesterone, 1:18.7:64.7; dehydroepiandrosterone (DHEA), 1:10.4:35.6; androstenedione (A), 1:24.4:92.3; testosterone (T), 1:18.6:69.2; and estradiol (E2), 1:11.0:26.3. The peripheral levels of hormones before left salpingo-oophorectomy were T, 7.5 ng/ml; DHEA, 19.9 ng/ml; A, 12.3 ng/ml; and cortisol, 11.4 micrograms/dl. Corresponding levels at 14 days after surgery were (0.75 ng/ml; 5.84 ng/ml; 1.94 ng/ml; and 15.6 micrograms/dl, respectively. Preoperatively, an elevated basal level of luteinizing hormone (LH) and a normal basal level of follice-stimulating hormone (FSH) (high LH:FSH ratio) were found. These data suggest that 1) androgens from the androblastoma are responsible for virilization despite aromatizing enzyme activities within normal limits, and 2) both the delta 5 and delta 4 pathways are involved in the biosynthesis of androgens, with that of delta 5 being predominant.

Topics: Adolescent; Androgens; Androstenedione; Dehydroepiandrosterone; Estradiol; Female; Humans; Hydroxyprogesterones; Luteinizing Hormone; Menotropins; Ovarian Neoplasms; Paraneoplastic Endocrine Syndromes; Progesterone; Sertoli-Leydig Cell Tumor; Testosterone; Virilism

Proliferating tumor cells obtained from ovarian, mammary, and endometrial tumors in tissue culture were tested for the influence of proteohormones and steroid hormones on cellular DNA synthesis and cell growth. The gonadotropic hormones stimulated DNA synthesis of ovarian tumor cells by single administration, or in combination with cortisol, up to the 11-fold of the comparable controls. The hormone sensitivity of the cell lines was variable, resulting in individual reaction patterns. There was no correlation to the histological diagnosis of the primary tumors with respect to the grade of differentiation. The results suggest that ovarian tumor cells in tissue culture can maintain sensitivity to organotropic hormones. Compared to the ovarian carcinoma lines, mammary or endometrial tumor cells did not respond to a similar extent. Progesterone decreased DNA synthesis of endometrial carcinoma cells.

Topics: Breast Neoplasms; Cell Division; Chorionic Gonadotropin; Culture Techniques; DNA, Neoplasm; Female; Follicle Stimulating Hormone; Hormones; Humans; Luteinizing Hormone; Menotropins; Neoplasms, Experimental; Neoplasms, Hormone-Dependent; Ovarian Neoplasms; Uterine Neoplasms

Topics: Adnexa Uteri; Adnexal Diseases; Adult; Anovulation; Chorionic Gonadotropin; Danazol; Endometriosis; Female; Humans; Infertility; Laparoscopy; Laparotomy; Male; Menotropins; Ovarian Neoplasms; Pregnancy; Pregnancy, Tubal; Preoperative Care; Urinary Bladder Neoplasms

Topics: Cells, Cultured; Chorionic Gonadotropin; Corpus Luteum; Culture Media; Culture Techniques; Female; Granulosa Cell Tumor; Humans; Menotropins; Middle Aged; Mitosis; Ovarian Neoplasms; Progesterone; Time Factors