[Multifactorial analysis of the blood levels of LH, FSH and estradiol in relation to ovular harvesting rates, fertilization and segmentation in patients undergoing assisted reproduction (GIFT-FIVTE)]. / Análisis multifactorial de los niveles séricos de LH, FSH y Estradiol en relación a las tasas de captura ovular, fertilización y segmentación en pacientes de reproducción asistida (GIFT-FIVTE).

This study shows that there is certain tendency to asssign more value to the observation of follicular growth by ultrasound than to hormonal levels "per se". However, the appreciation of growth is only part of the phenomenon of development and ovarian maturity, for that, surveillance with hormonal monitor of ovarian response keeps with a most important role in Assisted Reproduction Clinica. The basal levels, mainly of FSH and in a less degree LH, inversely correlate with the amount of retrieved ovocytes. Estradiol values should be interpreted with a fixed point of reference, as the day of HCG administration, and a direct relation is seen between estradiol levels and captured ovocytes; however, is of highest usefulness to value the conduct of estradiol level, with the knowledge that the prognosis for good capture rates improves with ascending values and above 700 pg in the day of HCG administration.

[Hypothalamo-hypophyseal amenorrhea. I. The clinical and laboratory manifestations]. / Amenorrea hipotálamo-hipofisaria. I. Manifestaciones clínicas y de laboratorio.

This study included 15 women 18-36 years old with primary or secondary amenorrhea, low FSH and LH, a negative response to clormadinone and serum prolactin (Prl) levels less than 20.0 ng/ml. The following tests were performed on alternate days: LH and FSH determinations every 20 minutes (pulses) during 2-4 hours (n = 15); LH and FSH response to a single dose of GnRH 100 micrograms IV (n = 15) and after administration of 100 micrograms IM of GnRH daily during four consecutive days (n = 7); TRH test 200 micrograms IV (n = 9); oral metoclopramide-Prl induced response (10 mg) (n = 2); one to three basal determinations of cortisol, estradiol (E2), T3, T4, and TSH (n = 15). All patients had serum E2 levels less than 10.0 pg/ml and none showed a regular LH or FSH pulsatility. In seven patients (group A) serum LH had a 10-30 fold increase above basal levels in response to GnRH, while the other eight patients (group B) showed no response at all; serum FSH changes were most irregular in both group. In group A no other hormonal deficiencies were detected, while in group B only three patients had an isolated LH-FSH deficiency, and in the other five this deficiency was accompanied by Prl, TSH, and/or ACTH lack. The present results suggest that: 1) group A represents isolated GnRH deficiency and the amenorrhea has hypothalamic etiology; 2) group B had LH-FSH deficiency of pituitary origin, in most cases associated to other pituitary hormone deficiencies; 3) the lack of LH response to an initial single dose of GnRH is not an absolute indicator of hypophyseal amenorrhea.

[ Growth hormone in patients with diabetes mellitus of the juvenile type]. / Hormona de crecimiento en pacientes con diabétes mellitus de tipo juvenil.

Blood glucose and growth hormone were measured in eight juvenile onset diabetic patients and in controls. Blood samples were obtained every 90--120 minutes for two consecutive days; in one of them, the patients received intermediate insulin, and in the other, they were also injected with additional doses of regular insulin, in order to improve their diabetic control. Normal subjects were studied in the same manner during 24 hs. without insulin. Diabetic patients showed significantly higher blood glucose and growth hormone levels when both insulins were used and only significantly higher blood glucose when they received intermediate insulin alone, than control subjects. They also showed significantly higher growth hormone and lower blood glucose levels on the day of intermediate insulin plus regular insulin than on the day of intermediate insulin. In two prebubertal controls, we observed growth hormone spurt only during sleep, while four adolescent controls showed it both while awake and asleep, as it was in all the diabetic patients we studied, including two prepubertal diabetics, one was 10 years old, and the other 13 9/12, with Turner's syndrom untreated with sexual hormones. We discuss our findings comparing with present day knowledge on this field.