menotropins and Pituitary-Neoplasms

Despite the efforts of a large number of investigators, the role of GnRH in clinical gynecology is uncertain. At present, its greatest utility is in research directed toward the understanding of hypothalamic-pituitary interrelationships. However, a clear understanding of the hypothalamic control of gonadotropin secretion awaits the actual measurement of the secretion of GnRH by the hypothalamus. In addition, a better understanding of the ability of the pituitary to secrete gonadotropins in various disorders of menstruation and maturation will probably be achieved through the determination of the capacity of the pituitary to synthesize as well as release gonadotropins in response to GnRH. Such determinations will probably utilize repeated or continuous infusions of GnRH rather than the currently more popular single injection technique. Finally, GnRH may be useful in the induction of ovulation. A definition of its role in ovulation induction awaits the results of additional clinical studies. Understanding of the nature of hypothalamic control of the pituitary is as yet incomplete. The availability of hypothalamic releasing factors will make it possible to study in greater detail the mechanisms by which the fine regulation of the endocrine system is achieved.

Topics: Adenoma; Amenorrhea; Clomiphene; Cushing Syndrome; Diabetes Mellitus; Disorders of Sex Development; Female; Galactorrhea; Humans; Hypogonadism; Hypothalamo-Hypophyseal System; Menotropins; Menstruation; Myotonic Dystrophy; Ovulation; Pituitary Diseases; Pituitary Neoplasms; Polycystic Ovary Syndrome; Postpartum Period; Pregnancy

A randomized, double-blind, placebo-controlled trial of cotreatment with biosynthetic, human sequence, growth hormone (GH), and human menopausal gonadotropins (hMG) for induction of ovulation was performed in 16 women with amenorrhea and anovulatory infertility. Patients were randomly allocated to treatment with hMG + GH (24 IU on alternate days, total dose 144 IU) or hMG + placebo. Those who received placebo were given GH in a subsequent course of treatment. On cotreatment with GH compared with placebo, there was a significant reduction in the required dose of hMG, duration of treatment, and the daily effective dose of gonadotropins. Serum insulin-like growth factor-I (IGF-I) rose during treatment with GH but not with placebo. We conclude that growth hormone augments the response of the human ovary to stimulation by gonadotropins. These results suggest a role for the use of GH in induction of ovulation.

Topics: Adult; Amenorrhea; Anovulation; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Female; Growth Hormone; Humans; Hypogonadism; Hypophysectomy; Infertility, Female; Insulin-Like Growth Factor I; Insulin-Like Growth Factor II; Menotropins; Ovulation Induction; Pituitary Neoplasms; Random Allocation

To present the first gonadotropinoma presenting as pseudo-menopause in a teenager.. Human menopausal gonadotropins (hMG) were given to a 37-year-old woman whose hypergonadotropic amenorrhea with estrogen deficiency as a teenager was changed to hypogonadotropic amenorrhea by the growth and prolactin secretion of a macroprolactinoma.. The patient responded multiple times, and every time to stimulation with hMG and each time produced several dominant follicles. She delivered two babies including conception at age 40.. The fact that this woman could respond consistently to hMG 20 years after the diagnosis of premature menopause, it is clear that initially the etiology of the extremely high LH and FSH levels in an estrogen-deficient 18-year-old was the presence of gonadotropinoma secreting inert LH and FSH. Since serum prolactin was measured the first time at age 37, it is not clear whether the endogenous biologically active gonadotropine were suppressed by replacement of the gonadotroph cells with tumor cells or suppression of endogenous gonadotropins by hyperprolactinoma.

Topics: Adult; Amenorrhea; Diagnosis, Differential; Estrogen Replacement Therapy; Female; Follicle Stimulating Hormone; Humans; Luteinizing Hormone; Menotropins; Ovulation Induction; Pituitary Neoplasms; Pregnancy; Primary Ovarian Insufficiency; Progesterone; Prolactin; Prolactinoma

The authors report a rare case of a patient with panhypopituitarism who became pregnant by gonadotropin therapy and gave birth to a healthy baby. A brain tumour and/or the surgical resection of a brain tumour occasionally results in pituitary dysfunction. An 18-year-old Japanese patient developed hypogonadotropic secondary amenorrhoea because of a craniopharyngioma, which was surgically removed. The patient came to us, and peripheral blood was collected every 15 minutes for four hours. The levels of luteinising hormone (LH) and follicle-stimulating hormone (FSH) were measured. Results showed that LH and FSH levels were very low and did not fluctuate. Several years later, the patient complained of infertility, and treatment with human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) was started. The therapy was repeated for several cycles, but she did not conceive, so hMG-hCG therapy combined with conjugated oestrogen administration was started. The patient became pregnant at the seventh cycle of this combined therapy. She was not treated with supplementary growth hormone.

Topics: Adolescent; Adult; Chorionic Gonadotropin; Craniopharyngioma; Estrogens; Female; Fertility Agents, Female; Humans; Hypogonadism; Menotropins; Pituitary Neoplasms; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome

Ovarian hyperstimulation syndrome (OHSS) is the most serious, life-threatening, iatrogenic complication of ovulation induction. The importance of excessive oestradiol concentrations on the day of human chorionic gonadotrophin (HCG) administration as a predictor and factor in the pathophysiology of OHSS has been extensively studied and discussed. We present the case report of a woman with hypogonadotrophic hypogonadism who developed severe OHSS during ovulation induction with urinary human follicle stimulating hormone (FSH) and HCG in the presence of low circulating oestradiol concentrations. The implication of FSH treatment and complications in hypogonadotrophic hypogonadal patients, and the role of preovulatory oestradiol concentrations in the prediction of OHSS, are discussed.

Topics: Adult; Chorionic Gonadotropin; Craniopharyngioma; Estrogens; Female; Humans; Hypogonadism; Menotropins; Ovarian Hyperstimulation Syndrome; Ovulation Induction; Pituitary Neoplasms

We report on two males with prolactinoma in whom hyperprolactinaemia and hypogonadism persisted for several years postoperatively despite the administration of a dopamine agonist or bromocriptine. In these patients, a GnRH test revealed no response in the levels of serum LH or FSH. An hCG stimulation test provoked no response in the serum levels of testosterone. Case 1, who was 28 years old at the first visit, received parenteral testosterone and appreciable virilization of the genitalia was noted within a few months. When he married and desired to father a child, the treatment was switched to hCG/hMG combined therapy and spermatozoa appeared subsequently in the ejaculate, although their numbers were low. His wife conceived and delivered a healthy baby girl. Case 2 was a single young man who presented with hypogonadotrophic hypogonadism and hyperprolactinaemia. He was started on hCG injections three times per week and the maturation of his genitalia was advanced rapidly. Semen analyses showed sperm concentration and motility to be within the normal range. Post-treatment GnRH test revealed no improvement in gonadotrophin responses for LH or FSH. In both cases, the hCG test repeated after the gonadotrophin treatment showed normal basal and stimulated testosterone levels. During the course of gonadotrophin treatment in these cases, serum prolactin levels remained elevated, and it is suggested that, in the two cases, the hypothalamo-pituitary function was disturbed by the tumour or its manipulation and the capacity of the pituitary gland to secrete gonadotrophin was impaired. Under such circumstances with persisting hyperprolactinaemia, hCG and/or hCG/hMG combination treatment can induce normal virilization and advance spermatogenesis sufficiently to achieve fertility.

Topics: Adult; Chorionic Gonadotropin; Gonadotropins; Humans; Hyperprolactinemia; Hypogonadism; Male; Menotropins; Pituitary Neoplasms; Postoperative Complications; Prolactinoma

A 38-year-old woman ovulated and conceived after administration of human menopausal gonadotropins despite a previous diagnosis of ovarian failure at age 18. Possible explanations include restoration of down-regulated gonadotropin receptors by development of a prolactinoma, spontaneous remission of autoimmune oophoritis, or prior tumor secretion of biologically inert gonadotropins.

Topics: Adenoma; Adult; Female; Humans; Hypophysectomy; Menotropins; Ovarian Diseases; Ovulation; Pituitary Neoplasms; Postoperative Period; Pregnancy

A previously hypophysectomized man with azoospermia, who was on androgen replacement therapy since 11 years, was studied with regard to his intratesticular steroid conversion capacity in vitro after which he was given combined hCG/hMG therapy. Before therapy a steroid conversion pattern similar to that seen in prepubertal boys was found, i.e. a high proportion of 20 alpha-dihydroprogesterone was produced while only smaller amounts of 17 alpha-hydroxyprogesterone was produced from the substrate 3H-progesterone. After only five weeks of hCG/hMG treatment, sperm counts and serum testosterone levels increased dramatically and a child was conceived. The steroid conversion pattern simultaneously switched to the mature, adult type with a low production of 20 alpha-dihydroprogesterone and large amounts of 17 alpha-hydroxyprogesterone being produced in vitro. Thus gonadotrophin substitution therapy may still be very effective after long term androgen replacement.

Topics: Chorionic Gonadotropin; Combined Modality Therapy; Craniopharyngioma; Drug Therapy, Combination; Female; Humans; Infertility, Male; Long-Term Care; Male; Menotropins; Oligospermia; Pituitary Irradiation; Pituitary Neoplasms; Postoperative Complications; Seminiferous Epithelium; Sexual Maturation; Sperm Count; Sperm-Ovum Interactions; Spermatogenesis; Testis; Testosterone

A case is presented of a twenty-nine-year-old acromegalic man with sexual problems and fertility disturbance due to pituitary adenoma, who successfully fathered. Various endocrinologic studies, skill x-ray film, and computerized tomography (CT) scan revealed a pituitary adenoma. Testicular biopsy specimen also supported that the cause of sexual problems and fertility disturbance was secondary in origin. One month after transsphenoidal pituitary adenectomy, administration of human chorionic gonadotropin and human menopausal gonadotropin was started. His potency was improved immediately after start of the treatment, and his wife became pregnant five months later.

Topics: Acromegaly; Adenoma; Adult; Chorionic Gonadotropin; Humans; Infertility, Male; Male; Menotropins; Pituitary Neoplasms

Topics: Adenoma; Adult; Bromocriptine; Chorionic Gonadotropin; Drug Resistance; Humans; Infertility, Male; Male; Menotropins; Pituitary Neoplasms; Prolactin

The enzyme 17 alpha-hydroxylase catalyzes the conversion of progesterone to 17 alpha-hydroxyprogesterone in the testis and may be studied with the use of incubation of testicular tissue with [3H] progesterone in vitro. The enzyme 20 alpha-hydroxysteroid dehydrogenase catalyzes the conversion of progesterone to 20 alpha-dihydroprogesterone. These enzymes were studied in testicular tissue from 105 human males regarding the effects of aging, different pathophysiological conditions, and gonadotrophic or estrogenic treatment. 17 alpha-Hydroxylase activity was low in vitro in testicular tissue from prepubertal boys, adult men with pituitary tumors, and estrogen-treated elderly men. In nontreated elderly men and certain infertile adult men, 17 alpha-hydroxylase was more active than in the above-mentioned patient groups, albeit lower than in adolescent and adult men. Gonadotropic treatment increased the conversion mediated by 17 alpha-hydroxylase in prepubertal as well as adult testicular tissue. In conclusion, the activity of 17 alpha-hydroxylase may be influenced by gonadotrophic hormones and may be an indicator of the testicular endocrine state at the moment of biopsy. Testicular 20 alpha-hydroxysteroid dehydrogenase seems to be active during low gonadotrophic influence and might even be inhibited by gonadotrophic stimulation.

Topics: 20-Hydroxysteroid Dehydrogenases; Adolescent; Adult; Aging; Child; Child, Preschool; Chorionic Gonadotropin; Cryptorchidism; Estrogens; Female; Humans; In Vitro Techniques; Infertility, Male; Male; Menotropins; Pituitary Neoplasms; Pregnancy; Progesterone; Puberty; Steroid 17-alpha-Hydroxylase; Testis

We have investigated the effects of ovine corticotrophin releasing factor (oCRF) and its interaction with hydrocortisone (HC), and arginine vasopressin (AVP) on ACTH release from human corticotrophinoma cells in culture. Tumour tissue was obtained from six patients (three with active Cushing's disease and three with Nelson's syndrome). Cultures were maintained for periods of up to six months. Ovine CRF (21 nmol) significantly (P less than 0.01) stimulated ACTH release from all tumours. Dose response (21 pmol-21 nmol) effects were observed for the three tumours investigated over 2 and 4 h. Cortisol (20 mumol) significantly (P less than 0.01) inhibited basal ACTH release from one tumour (Nelson's syndrome) by 75% over 4 h, and completely prevented the stimulatory effects of oCRF. AVP directly stimulated ACTH release from two tumours (Nelson's syndrome), and also potentiated the stimulatory action of oCRF during 30 min incubations. These data show corticotrophinoma cells from subjects with Cushing's disease and Nelson's syndrome can be directly stimulated by hypothalamic oCRF and may be potentiated by AVP. Cortisol and oCRF have been shown in one tumour to have antagonistic actions at the pituitary level.

Topics: Adrenocorticotropic Hormone; Animals; Arginine Vasopressin; Cells, Cultured; Corticotropin-Releasing Hormone; Dose-Response Relationship, Drug; Drug Synergism; Humans; Hydrocortisone; Menotropins; Pituitary Neoplasms; Sheep; Stimulation, Chemical

Topics: Adenoma; Anovulation; Bromocriptine; Clomiphene; Female; Gonadotropin-Releasing Hormone; Humans; Menotropins; Ovulation Induction; Pituitary Neoplasms; Prolactin

Two men with primary infertility after 6 to 11 years of marriage were found to have isolated follicle-stimulating hormone deficiency syndrome (IFDS). Their endogenous gonadotropin secretion was compared with that of two other infertile men with hypothalamic disease (Kallmann's syndrome) and pituitary tumor with hyperprolactinemia. Treatment with intramuscular gonadotropin was given to produce circulating and 24-hour urine levels of luteinizing hormone and follicle-stimulating hormone at or above the upper limit of the normal male range to ensure continued gonadal stimulation. Sperm counts increased in IFDS men within 6 to 26 weeks, with maximum total sperm counts of 33.5 and 20 million after 9 to 80 weeks. Pregnancy occurred after 20 weeks' therapy in one patient's wife with the subsequent delivery of a normal male infant. IFDS may be a treatable cause of male infertility given adequate gonadotropin therapy.

Topics: Adult; Chorionic Gonadotropin; Follicle Stimulating Hormone; Humans; Hypothalamic Diseases; Infertility, Male; Luteinizing Hormone; Male; Menotropins; Pituitary Neoplasms; Prolactin; Sex Hormone-Binding Globulin; Sperm Count; Spermatogenesis; Time Factors

Topics: Bromocriptine; Female; Humans; Menotropins; Pituitary Neoplasms; Pregnancy; Prolactin

The case of a patient who developed partial hypopituitarism (hypogonadotropism and growth hormone deficiency) following transphenoidal removal of a prolactinoma is described. Hypogonadotropism persisted despite restoration of normoprolactinemia with bromocriptine therapy. Successful induction of ovulation with human menopausal gonadotropin (hMG) and bromocriptine suppression of the hyperprolactinemia was carried out, resulting in a pregnancy. The pros and cons of operative and nonoperative management of hyperprolactinemia are discussed.. A case report is presented of the need for both bromocriptine and human menopausal gonadotropin (hMG) for induction of ovulation in a patient who developed partial hypopituitarism and persistent hyperprolactinemia even after a transsphenoidal pituitary microadenectomy. The patient, a 27-year old white female, initially presented in 1979 with a history of amenorrhea and galactorrhea after discontinuing oral contraceptives (OCs). Her menstrual cycles had been regular since her menarch at age 13 until she began taking OCs at age 20. Preoperative endocrine evaluation in 1979 revealed serum luteinizing hormone (LH), 9.1 mIU/ml; serum follicle stimulating hormore (FSH), 6.4 mIU/ml; serum thyroid stimulating hormone (TSH), 3.8 mIU/ml; serum prolactine (PRL), 300 ng/ml; serum thyroxine (T4), 6.4 mcg/dl; and an attenuated PRL response to thyrotropin releasing hormone (TRH). Radiographic studies revealed a pituitary tumor of approximately 1 cm in diameter. In July 1979 a transsphenoidal hypophysectomy was performed. Pathologic examination revealed a pituitary adenoma with a monomorphic basophilic cell population with fibrosis and chronic inflammation. The patient required prednisone therapy postoperatively for 3 months secondary to compromised adrenal status. Prednisone therapy was discontinued in October 1979 after a normal cortisol (F) response to induced hypoglycemia was documented. The patient's serum PRL levels remained elevated at 111 ng/ml in August 1979 and 269 ng/ml in October 1979. Her amenorrhea and galactorrhea persisted. Bromocriptine therapy, 2.5 mg 3 times daily, was instituted in October 1979. She became normoprolactinemic, with a serum PRL of 6 ng/ml, and the galactorrhea disappeared but the amenorrhea persisted. In February 1981 she was referred for further consultation on her fertility status. Bromocriptine therapy was discontinued. In April 1981 she underwent a thorough endocrine evaluation. The results indicate that GnRH stimulation was unable to elicit a pituitary gonadotropin response anywhere near normal levels of FSH and LH, thus suggesting pituitary hypogonadotropism. Growth hormone release was subnormal in response to the insulin induced hypoglycemia and L-dopa ingestion. Hyperprolactinemia was obvious but the patient's serum TSH, T4, and adrenocorticotropin (ACTH) levels were normal. A diagnosis of hyperprolactinemia with partial hypopituitarism and gonadotropin deficiency was made. Bromocriptine therapy was reinstitu

Topics: Adult; Bromocriptine; Female; Follicle Stimulating Hormone; Growth Hormone; Humans; Hypopituitarism; Luteinizing Hormone; Menotropins; Ovulation Induction; Pituitary Neoplasms; Prolactin

Sixty-nine pregnancies were observed in 57 hyperprolactinemic women (5 with pituitary macroadenoma, 20 with microadenoma, and 32 with normal tomography of the sella turcica). Ten of these pregnancies took place spontaneously in women with mild to moderate hyperprolactinemia (up to 70 ng/ml); 2 were induced by exogenous gonadotropins, 2 by clomiphene, 42 by bromocriptine, and 9 by metergoline; and 4 occurred after pituitary selective adenomectomy. The observed complications included spontaneous abortion (10 cases); headache (7 cases); sellar enlargement (5 cases); and bitemporal hemianopsia (1 subject with macroadenoma). Among 24 women in whom prolactin levels were reevaluated at least 1 month after parturition and/or lactation, 8 showed a decrease in prolactin concentration (less than 50% of pregestational levels), with actual prolactin normalization in 3 and resumption of cyclic menses in 2 previously amenorrheic women. In contrast, no changes in prolactin levels occurred after pregnancies that ended in abortion. These data suggest the following: 1) conception is not uncommon in women with moderate hyperprolactinemia; and 2) pregnancy may be safely induced without prior surgery and/or radiotherapy in hyperprolactinemic women, except those with large pituitary adenomas, and a considerable number of these patients even show a clinical and biochemical improvement after pregnancy.

Topics: Adenoma; Bromocriptine; Chorionic Gonadotropin; Clomiphene; Female; Humans; Infertility, Female; Menotropins; Metergoline; Ovary; Ovulation Induction; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Prolactin

Topics: Abortion, Spontaneous; Anovulation; Chorionic Gonadotropin; Female; Gonadotropins, Pituitary; Humans; Infertility, Female; Menotropins; Ovulation Induction; Pituitary Neoplasms; Pregnancy; Pregnancy, Multiple

Ovulation induced with human menopausal gonadotropin-human chorionic gonadotropin in a 27-year-old woman who had been amenorrheic for 7 years resulted in pregnancy. Although pretreatment neurologic evaluation was normal, significant loss of vision was found at 30 weeks' gestation, and a skull x-ray revealed enlargement and erosion of the sella turcica. As an attempt to delay surgery, 12 mg of dexamethasone daily arrested further visual deterioration, and the pregnancy continued uneventful for 36 weeks, when triplets were born. Five days after delivery the visual fields were normal. Trans-sphenoidal resection of a prolactin-secreting chromophobe adenoma of the pituitary was carried out 6 months later. It is suggested that when disturbance in visual perception due to a pituitary tumor occurs during pregnancy, a course of high-dose corticosteroids with frequent monitoring of visual fields and acuity might be tried before surgical intervention. Although further rapid deterioration in vision may dictate immediate surgical decompression, conservative management may result in stabilization, allowing the patient to carry the pregnancy to term and obviating the need for emergency surgery.

Topics: Adenoma, Chromophobe; Adult; Chorionic Gonadotropin; Dexamethasone; Female; Humans; Infertility, Female; Menotropins; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Pregnancy, Multiple; Triplets; Vision Disorders; Visual Fields

Prolactin levels during a gonadotropin-induced pregnancy have not been previously reported. A patient with Forbes-Albright syndrome is described. She received radiation therapy, with cessation of her galactorrhea, but she remained amenorrheic. Three years after irradiation, a pregnancy was successful induced with human menopausal gonadotropins and human chorionic gonadotropin. Prolactin levels determined prior to gonadotropin therapy, during an insulin hypoglycemia stimulation test, serially during pregnancy, and postpartum during lactation are presented. These levels are compared with the previously reported levels for basal prolactin, response to insulin hypoglycemia, pregnancy, and lactation. Possible etiologies for the abnormal values and responses obtained from investigation of this patient are discussed.

Topics: Adult; Amenorrhea; Female; Galactorrhea; Humans; Insulin; Lactation; Menotropins; Ovulation; Pituitary Neoplasms; Pregnancy; Prolactin

The authors report a case of amenorrhoea with galatorrheoa due to a prolactin adenoma secondary to an inducer of ovulation (HMG and HCG) and in which pregnancy occurred. There was sudden progression of the adenoma with formation of a haematoma and the necessity for emergency surgery. In the light of this case, the risks and indications of inducers of ovulation in the sterile woman complaining of amenorrhoea with galactorrhoea are discussed.

Topics: Adenoma; Adult; Amenorrhea; Chorionic Gonadotropin; Female; Fertility Agents, Female; Galactorrhea; Humans; Hypophysectomy; Infertility, Female; Menotropins; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Prolactin; Radiography; Sella Turcica

Topics: Adenoma, Chromophobe; Adolescent; Adult; Amenorrhea; Anovulation; Chorionic Gonadotropin; Female; Gonadotropins, Equine; Humans; Menotropins; Pituitary Neoplasms; Pregnancy

Nine pregnancies are described in patients with pituitary tumours. All patients had definite radiological evidence of a pituitary tumour and no evidence of acromegaly or Cushing's disease. In seven patients serum prolactin levels were estimated before pregnancy and found to be raised.Seven patients had been treated with pituitary implantation of yttrium-90. The remaining two developed complications of the tumour during pregnancy. One developed a bitemporal visual field defect in the second trimester which was successfully treated by emergency yttrium-90 implantation. The other developed diabetes insipidus in the third trimester which resolved spontaneously after delivery.Six patients were treated with drugs to achieve pregnancy. Four took bromocriptine to suppress raised prolactin levels, one was treated with human menopausal gonadotrophin, and one was treated with clomiphene.

Topics: Adult; Amenorrhea; Bromocriptine; Clomiphene; Diabetes Insipidus; Female; Humans; Labor, Obstetric; Menotropins; Pituitary Neoplasms; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Prolactin; Vision Disorders; Visual Fields; Yttrium Radioisotopes

Topics: Adenoma, Acidophil; Adenoma, Chromophobe; Adult; Chorionic Gonadotropin; Estrogens; Female; Gonadotropins; Gonadotropins, Pituitary; Humans; Hydrocortisone; Infertility, Female; Injections, Intramuscular; Menotropins; Ovulation; Pituitary Neoplasms; Postoperative Complications; Pregnancy; Progesterone; Thyroid Hormones

Out of 210 women seen at the Middlesex Hospital with secondary amenorrhoea the 63 who developed it after stopping oral contraceptives were fully investigated. Five had organic disease sufficient to account for the amenorrhoea (one had severe diabetes, one a pituitary tumour, and three premature ovarian failure); two patients had galactorrhoea (one of whom also had the pituitary tumour); two had anorexia nervosa.Of the 63 women 40 (63%) had suffered from amenorrhoea or prolonged or irregular menstrual cycles before taking the pill, and this suggested that combined oestrogen-progestogen oral contraceptives should be used with caution for women with irregular menstruation.Nineteen patients wished to become pregnant and 12 have so far done so after treatment with clomiphene or gonadotrophins.In another study 204 women recorded when their first menstrual cycle occurred after stopping the pill. Seventy-four had a cycle longer than five weeks but only five exceeded three months, and only one of the five had more than six months' amenorrhoea. These results confirm that the incidence of amenorrhoea after stopping oral contraceptives is low.

Topics: Adult; Affective Symptoms; Amenorrhea; Clomiphene; Contraceptives, Oral; Diabetes Complications; Estrogens; Female; Humans; Infertility, Female; Menotropins; Menstruation; Ovarian Diseases; Pituitary Neoplasms; Progestins; Prospective Studies; Time Factors

Topics: Adenoma; Adult; Female; Humans; Hypophysectomy; Menotropins; Ovulation; Pituitary Neoplasms; Pregnancy; Pregnancy Complications