RESUMO
The use of measuring urinary steroid conjugates in nontimed, randomly collected morning urine samples expressed as a function of creatinine concentration was assessed to monitor ovarian response to pulsatile administration of gonadotropin-releasing hormone in ambulatory patients. This method of evaluating ovarian steroid production provided a convenient, inexpensive, and noninvasive means of monitoring responses to gonadotropin-releasing hormone treatments and documents that clomiphene-resistant amenorrheic patients can be induced to ovulate with appropriate gonadotropin-releasing hormone therapy. Different ovarian responses in the same woman to similar doses and frequencies of gonadotropin-releasing hormone indicate that discrete adjustments of individual doses may be required to facilitate consistent ovulatory responses. The strategy presented here allows for subsequent gonadotropin-releasing hormone therapy in the individual patient to be determined by an objective and quantifiable ovarian response to an initial treatment.
Assuntos
Infertilidade Feminina/tratamento farmacológico , Hormônios Liberadores de Hormônios Hipofisários/administração & dosagem , Esteroides/urina , Adulto , Amenorreia/tratamento farmacológico , Creatinina/urina , Estrogênios/urina , Feminino , Humanos , Infertilidade Feminina/metabolismo , Ciclo Menstrual , Ovulação/efeitos dos fármacos , Hormônios Liberadores de Hormônios Hipofisários/metabolismo , Pregnanodiol/urina , RadioimunoensaioRESUMO
When metkephamid, a systemically active analog of methionine enkephalin, was administered intracisternally to male or female prepubescent lambs as early as the first week of life, we observed a behavioral pattern akin to Flehmen, which is a well-characterized grimace displayed by mature ungulates during mating. This metkephamid-induced Flehmen was preceded by transient bradycardia and apnea followed by somnolence for approximately 1 hour, during which Flehmen was observed intermittently. Pretreatment with the specific opiate antagonist, naloxone, blocked this behavioral response. These observations indicate that endogenous opioid peptides may be involved in Flehmen.