A relationship between sperm count and intracellular progesterone, 17 alpha-hydroxyprogesterone, and cortisol concentrations in human spermatozoa.

In an attempt to determine whether human spermatozoa contain steroid hormones, in this study we have measured the immunoreactive levels of P, 17 alpha-OHP, and F in the extracts of sonicated specimens of sperms obtained as ejaculates from husbands of infertile couples. The results of this study demonstrate for the first time that human spermatozoa contain definite amounts of the measured steroids and suggests an association between steroid levels and sperm count. These steroids identified intracellularly in the haploid germ cells may play a role in the molecular events associated with fertilization.

In vitro formation of testosterone via the delta 5-pathway in the human umbilical cord.

Homogenates of two groups of term umbilical cord (n = 6, 37-40 weeks; n = 6, 38-40 weeks) were separately incubated with [7n-3H]pregnenolone and [1,2,6,7-3H]dehydroepiandrosterone. Using the reverse-isotope dilution technique, [3H]dehydroepiandrosterone and [3H]testosterone formed from the respective substrates were isolated and characterized. The extent of enzymic conversions were 0.015-0.28% and 0.044-2.2%. These results provide evidence for the metabolic transformation of pregnenolone to testosterone via the delta 5-3 beta-hydroxy route.

Plasma estradiol-17 beta as an index of fetoplacental function.

Serial plasma unconjugated estradiol-17 beta was measured by a radioimmunoassay method in 26 cases of hypertensive disorder of pregnancy, 13 cases of poor obstetric history and 4 cases of intra-uterine growth retardation. There was considerable overlap of hormonal values between pregnancies, resulting in delivery of normal fetuses and those with dysmature fetuses. Serial estimation of estradiol-17 beta were not found to be useful in the prediction of intra-uterine death, although low values were obtained after fetal death has occurred. Estradiol-17 beta estimation appeared to be an unreliable index of fetoplacental function.

Human chorionic somatomammotropin in normal pregnancy in an Asian population.

Serial Human Chorionic Somatomammotropin (HCS) levels were measured during the last 10 weeks of pregnancy in 57 patients (375 samples). There was a gradual rise from 5.6 microgram/ml at the 30th week to microgram/ml at the 40th week, with a plateau during the last 4 weeks of pregnancy. No correlation could be found of HCS levels with parity, maternal age, maternal height, maternal weight, foetal weight and foetal sex. A weak but significant relationship was found between HCS and plasma oestriol (r = 2.4, p less than 0.001).

Elevated peritoneal fluid luteinizing hormone and prolactin concentrations in infertile women with endometriosis.

In this study, we compared (Mann-Whitney U-test) the peritoneal fluid FSH, LH and PRL levels, measured by RIA, at the follicular and luteal phases of the menstrual cycle in women with (n = 43; age 25-44 years) and with no evidence of endometriosis (n = 35; age 25-39 years) who were considered as controls. Both follicular and luteal phase FSH concentrations of women with endometriosis were not statistically different (n = 22 vs 18; 0.32-5.8 vs 0.50-8.2 IU/l, P = 0.247; n = 13 vs 14; 0.6-6.5 vs 0.66-6.7 IU/l, P = 0.604) compared to their respective controls. In contrast to FSH, the concentrations of LH at follicular (n = 19 vs 17; 3.1-34.2 vs 2.3-12.2 IU/l, P = 0.01) and luteal (n = 17 vs 15; 2.1-95.4 vs 1.3-17.9 IU/l, P = 0.02) phases of the test group was significantly elevated at both phases of the cycle. With respect to differences in PRL concentrations at follicular phase no significant change (n = 21 vs 16; 1030-5800 vs 1305-4650 mIU/l; P = 0.255) was observed. The greatest difference in luteal PRL concentrations (P = 0.007) was obtained between the women with endometriosis and controls (n = 17 vs 17; 1895-8600 vs 1041-5000 mIU/l). The results suggest that disordered synchronization of neuroendocrine mechanisms controlling LH and PRL may be the underlying abnormality causing infertility in our group of patients with endometriosis.

Experience of a comprehensive infertility clinic in the Department of Obstetrics and Gynaecology, University of Singapore.

PIP: The diagnosis, treatment, and pregnancy outcome for 709 infertile couples who attended the comprehensive infertility clinic of the University of Singapore's Department of Obstetrics and Gynecology from 1970-1974 are presented. Investigations for most of the couples were completed within 3 months. This short investigative period was attributable primarly to the use of laparoscopy to diagnose female infertility. In 22.5% of the 709 cases infertility was due to ovulation problems. After treatment eith either clomiphene, human pituitory gonadotrophin, or a combination of clomiphene and human chorinic gonadotrophin, pregnancy was achieved in 30.6% of the cases. 11.7% or 83 of the 709 infertility cases were attributed to blocked tubes. 28 of these patients received tubal surgery, but only 14.3% or 4 of these cases resulted in pregnancy. In 14.7% of the 709 cases, infertility was attributed to endometriosis. 90% of the patients with endometriosis were asymptomatic, and the liesons discovered by laparoscopy, were very small. Pregnancy eventually occurred in 27.6% of the cases treated for endometriosis. In 5.8% of the 709 cases infertility was due to mixed gynecological problems, and after treatment, conception occurred among 31.7% of the cases. For 23.1%, or 147 of the 709 couples, infertility was attributed to either oligospermia or azoospermia. 85 of the 147 patients were given hormone therapy and in 12.9% of these cases pregnancy was achieved. 14 of the 147 patients were treated with antibotics for 3-6 months and in 14.3% of these cases pregnancy was achieved. 9 of the 147 patients were surgically treated and in 4 of these cases pregnancy later occurred. 20 of the 147 couples were treated with artifical insemination of donor semen and in 25.0% of these cases pregnancy occurred. Another 19 of the 147 cases were treated with artificial insemination with the husband's semen and conception occurred in 26.8% of these cases. The remaining 22.1% of the 709 couples were apparently normal and 47.8% of these untreated couples later achieved pregnancy.^ieng

A comparative study of peritoneal fluid concentrations of oestradiol-17 beta, progesterone, and testosterone in controls and in patients with endometriosis.

To ascertain whether a cyclical variation exists in the steroid hormone concentration of the peritoneal fluid between controls and patients with endometriosis, we set out to measure the concentration of oestradiol--17 beta (E2), progesterone (P4), and testosterone (T) by specific radioimmunoassay in the peritoneal fluid of these 2 groups. Forty six patients (mean age, 30.1 +/- 6 years) with pelvic endometriosis and 32 control patients (mean age, 32.2 + 3.8 years) without endometriosis were studied. The significance of differences between groups was determined by the Mann-Whitney mu test. In the control group a significant rise in peritoneal fluid E2 (P = 0.017) and P4 (P = 0.048) levels was observed in the luteal phase compared to the follicular phase, but no such difference was noted in women with endometriosis. It is suggested that peritoneal fluid steroid hormone assays are not helpful in the evaluation of ovarian function in endometriosis.

Upper genital tract fluid oestradiol-17 beta, progesterone and testosterone concentrations during the menstrual cycle.

This study was to obtain evidence whether a cyclical pattern in the concentrations of oestradiol-17 beta, progesterone and testosterone exists in the upper genital tract fluid of women with normal menstrual cycles. The steroid concentrations at proliferative and luteal phases were n = 20 vs 17, 54.5-190.0 vs 44.2-827.1 pg/ml; 0.27-3.3 vs 3.4-46.5 ng/ml and 41.9-734.8 vs 85.7-991.2 pg/ml, respectively. The results were analysed according to Mann-Whitney U test. Significantly higher concentrations of oestradiol-17 beta (p = 0.0036) and progesterone (p = 0.0001) were found. The results suggest the existence of a cyclical variation and point to the ovary as the main source of output of the steroids.

Response of ovary in young women experiencing laparoscopy under general anaesthesia.

This study investigated whether changes in circulating levels of immunoreactive oestradiol-17 beta (E2), progesterone (P) and testosterone (T) occur in women at follicular (n = 18, age 25 to 39 years) and luteal (n = 17, 25 to 39 years) phases of the normal menstrual cycles, experiencing laparoscopy after intravenous sedation with general anaesthesia. The pre- and intra-operative follicular phase plasma steroid hormone concentrations were 153.5 +/- 84.3 vs 297.4 +/- 220.8 pg/ml for E2, 2.0 +/- 3.2 vs 3.3 +/- 3.8 ng/ml for P and 746.6 +/- 415.9 vs 1325.8 +/- 535.1 pg/ml for T, respectively. The corresponding luteal phase steroid levels were 259.7 +/- 120.2 vs 382.7 +/- 188.7 pg/ml, 7.0 +/- 4.8 vs 9.9 +/- 6.1 ng/ml and 819.4 +/- 355.7 vs 1703.5 +/- 1058.1 pg/ml. Using the Wilcoxon rank sum test, intra-operative hormone levels with the exception of P in the luteal phase were found to be significantly elevated (p < 0.05). The results suggest that laparoscopy under general anaesthesia evokes increased secretion of ovarian hormones, possibly via the activation of hypothalamo-pituitary-ovarian axis.