[Hypogonadotropic form of amenorrhea. Features of the functional state of hypothalamo-hypophyseal structures and the endocrine status]. / Gipogonadotropnaia forma amenorei. Osobennosti funktsional'nogo sostoianiia gipotalamo-gipofizarnykh struktur i éndokrinnyi status.

Study of the function of the hypothalamopituitary system in patients with hypogonadotrophic amenorrhea showed the activity of its structures which manifested by the presence of pulsed LH secretion in 70% of women; however, the parameters of pulsed secretion of gonadotropins were disordered: the pulses were chaotic and low-amplitude. Adenohypophyseal gonadotrophs were capable of reacting to the administered gonadotrophin-releasing hormone, but the parameters of this reaction differed from the normal. The endocrine status of patients with hypogonadotrophic amenorrhea was changed vs. that in health: prolactin level was reduced, growth hormone level increased, thyroid and adrenocortical function changed; the pattern of secretion of some adenohypophyseal trophic hormones (prolactin, STH, TTH) was also changed. The results permit a hypothesis that impairment of the common central mechanisms regulating the endocrine system underlies the development of this disease; basing on their findings, the authors propose new approaches to the correction of this abnormality.

[Hypogonadotropic form of amenorrhea. Principles of ovulation induction]. / Gipogonadotropnaia forma amenorei. Printsipy induktsii ovuliatsii.

Analysis of the clinico-anamnestic and endocrine parameters of the reproductive system of 45 patients with hypogonadotropic amenorrhea helped single out three types of this condition. Drug doses and schemes of their administration to induce ovulation were selected individually with due consideration for the initial functional status of the reproductive system. The authors defined the basic principles of ovulation induction in patients with hypogonadotropic amenorrhea: the patients should be carefully selected according to WHO classification, with due regard for their clinico-anamnestic data and the function of the reproductive system (hormonal functional test); drug doses for substitution therapy and protocols of their administration should be selected individually, with consideration for the degree of hypophyseal-gonadal insufficiency; daily double (ultrasonic and hormonal) monitoring is needed for the correction of ovulation induction protocols; the choice of the optimal time of administration of the "ovulatory" dose should be based on the findings of double monitoring indicating follicle size 19-20 mm and the maximal activity of steroidogenesis (350 to 400 pmol/liter estradiol per follicle). The possibility of using lutrelef, an analog of gonadotropin releasing hormone, for ovulation induction in patients with the hypothalamic form of gonadotropic amenorrhea was studied. The drug was administered in a pulsed mode using Zykloma+ device (Ferring, Germany). The advantages of a physiological principle of substitution therapy were demonstrated, although the induction of cycles was not appreciably improved by this method as against substitution therapy with human menopausal gonadotropin.

[Functional state of the reproductive system in patients with the hypogonadotropic form of amenorrhea during use of various protocols of ovulation induction with human menopausal gonadotropins]. / Osobennosti funktsional'nogo sostoianiie reproduktivnoi sistemy patsientok s gipogonadotropnoi formoi amenorei pri ispol'zovanii razlichnykh skhem induktsii ovuliatsii chelovecheskimi menopausal'nymi gonadotropinami.

Clinico-hormonal parameters of cycles stimulated with human menopausal gonadotropins in patients with hypogonadotropic amenorrhea and of spontaneous cycles in healthy women of reproductive age are compared. Estradiol hypersecretion in both phases of induced cycle was revealed: hydrocortisone in phase 1 and progesterone and testosterone in phase 2. Dexamethasone in daily dose 0.25 mg was administered for correction. This resulted in a noticeable reduction of estradiol hyperproduction in the first phase of stimulated cycles and in hyperandrogenism elimination. Folliculogenesis, ovulation, and early embryogenesis conditions in schemes of induction with human menopausal gonadotropins and dexamethasone therapy were close to physiologic ones, this resulting in increased share of fertile cycles.

[The characteristics of hypophyseal gonadotropic function in patients with hypogonadotropic amenorrhea against a background of pergonal ovulation stimulation]. / Osobennosti gonadotropnoi funktsii gipofiza u patsientok s gipogonadotropnoi amenoreei na fone stimuliatsii ovuliatsii pergonalom.

Forty-three ovulation cycles stimulated with human menopausal gonadotropin were examined in 31 patients with hypogonadotropic amenorrhea. Peripheral blood estradiol and luteinizing hormone were radioimmunoassayed. The findings indicate the possibility of recovery of adenohypophyseal gonadotropin autosecretion in the presence of human menopausal gonadotropin administration.

[The characteristics of the hormonal interrelationships in a pregnancy stimulated with parlodel]. / Osobennosti gormonal'nykh vzaimootnoshenii pri beremennosti, stimulirovannoi parlodelom.

The study of hormonal balance in the presence of pregnancy and labor in females with a history of infertility treated with parlodel failed to reveal any negative effect of elevated prolactin levels on the fetoplacental system. No differences in the course of pregnancy and labor were revealed as compared to the untreated age-matched. Weight and height figures of neonates born to parlodel-treated mothers were similar to those from the control group. There was no evidence of malformations or developmental defects in the studied group of neonates.

[Comparative analysis of fertile and infertile cycles during stimulation of ovulation with pergonal in patients with hypo- gonadotropic amenorrhea]. / Sravnite'lnyi analiz ferti'lnykh i neferti'lnykh tsiklov pri stimuliatsii ovuliatsii pergonalom u patsientok s gipogonado- tropnoi amenoreei.

A comparative assessment of variations in sex hormone levels and echographic parameters of fertile and infertile cycles was carried out in patients with gonadotrophic deficiency during pergonal induction of the ovulation. It was demonstrated that 83% of the infertile cycles were the first stimulation cycles. Basic differences were identified in the variation of sex hormone levels and echographic parameters of target organs between the fertile and infertile cycles. It is concluded that the first ovulation-induction course should be regarded as a preventive or preparatory one, where an optimum drug dosage is adjusted while the gonads and target organs are getting ready for the ovulation.

[Function of the reproductive system in pre- and pubescent girls with diffuse toxic goiter and hypothyroidism]. / Sostoianie reproduktivnoi sistemy u devochek pre- i pubertatnogo vozrasta s diffuznym toksicheskim zobom i gipotireozom.

Altogether 70 girls of pubertal age were examined: 50 with diffuse toxic goiter and 20 with hypothyrosis. A clinical picture of "hypoestrogenism" and menstrual disturbance confirmed by the results of clinical and gynecological examination and ultrasonic investigation was noted in the patients. A significant rise of the level of gonadotropic hormones correlating with the severity of disease, and a rise of the level of testosterone-estradiol binding protein were revealed. The results of the investigation suggest that changes in the reproductive system resulting from thyroid dysfunction age determined by disturbance of different links of hormonal regulation of the hypothalamo-hypophyseal-gonadal system.

[Intracellular distribution of estradiol and estrogen binding sites in the uterus and oviducts of the green monkey (Cercopithecus griseus)]. / Vnutrikletochnoe raspredelenie éstradiola i éstrogensviazyvaiushchikh mest v matke i iaitsevodakh zelenoi martyshki (Cercopithecus griseus).

Plasma estradiol (E2) and progesterone (P) concentrations, E2 and estrogen binding sites (EBS) content in the uterus and oviducts of green monkey (Cercopithecus griseus) were measured during different phases of the menstrual cycle. Plasma E2 and P patterns were practically identical to those of African-Asian monkeys and humans. The E2 and EBS levels in various subcellular fractions were also determined. The correlations between these parameters were shown to be in accordance with the active mass law for monomolecular interaction at equilibrium state and might vary at different phases of the cycle. The alteration is probably attributable to variations in the activity of estrogen-receptor interaction during the menstrual cycle.

[Possible heterogeneity of cytoplasmic estrogen receptors]. / K voprosu o vozmozhnoi geterogennosti tsitoplazmaticheskikh éstrogennykh retseptorov.

In order to elucidate whether specific estrogen-binding sites were heterogeneous, these sites were studied in uterine cytosols of guinea pig and green monkey Cercopithecus griseus. Concentrations of the estrogen-binding sites for labelled estrogens (estrone, estradiol, estriol and diethylstilbestrol) were estimated in the cytosols by means of the exchange method and Scatchard plot analysis. High linear correlation was shown between the Scatchard plots and the curves of estrogen-binding site complexes dissociation plotted in semilogarithmic coordinates (r-0.98 and 0.99, respectively; p less than 0.05). The linearity of the curves was confirmed by means of F-criterion. The data obtained suggest that only one type of specific estrogen-binding sites occurs in the cytosols at 30 degrees and at concentration of estrogens which did not exceed 50 nM. These estrogen-binding sites exhibited the same limited binding capacity for all the estrogens studied.

[Binding of a series of estrogens to the estrogen receptor system of guinea pig hypothalamo-hypophyseal structures]. / Izuchenie osobennostei sviazyvaniia riada éstrogenov s éstrogen-retseptornymi sistemami gipotalamo-gipofizarnykh struktur morskikh svinok.

The specificity of estrogen-receptor (ER) interaction was studied in cytosols of the adenohypophysis and anterior hypothalamus of guinea-pigs. The fundamental condition of active ER binding was shown to be the integrity of 17 beta- and C3-positions of the estradiol molecule excepting compounds with the combination of 17 beta-OH and 17 alpha-ethinyl groups. Significant differences were demonstrated in the affinity of the test compounds to ER systems of hypophyseal and hypothalamic cytosols.