Continuous monitoring of plasma FSH, LH, HCG and placenta lactogen during HMG-induced ovulatory cycles and subsequent pregnancies.

Abstract

ABSTRACT This study gives a description of the pattern of plasma FSH, LH/HCG, and HPL in four patients with sterility problems suffering from ovarian insufficiency. Plasma values were assayed daily during HMG- and HCG-treatment, in the luteal phase and in the first few weeks of subsequent pregnancy by the dioxane and propanol precipitation radioimmunoassays. From the data obtained the following conclusions may be drawn: HMG-treatment induces no or only a slight increase in plasma LH as compared with normal follicular phases. A cumulative effect does not become evident, probably due to the short half-life of 21 minutes and 4 hours respectively. Injection of 10 000 to 15 000 IU HCG causes a marked increase in plasma level above 200 mU/ml and a subsequent depression in 4 to 5 days, corresponding to the long half-life of 5 and 23 hours respectively. During the five days before the rise in endogenous HCG/LH, values are in the same range or somewhat higher than during HMG-treatment and than in normal luteal phase. Between the 10th and 11th day after HCG injection a very sharp rise in endogenous HCG is observed, reaching 10 IU/ml within 15 to 20 days. FSH levels in the treatment period are augmented above the levels observed in normal follicular phases. Though there is no peak around the time of ovulation, a relative high FSH content can be noted. During the luteal phase FSH-values remain elevated and are higher than in normal cycles. Parallel to the rise in HCG, the FSH falls and is found to be very low during early pregnancy. In one patient with severe ovarian hyperstimulation the FSH concentration was different, with high levels in the first few weeks of pregnancy. Measurable HPL production was first detectable between day 28 and 32 after the ovulatory HCG peak. By the 10th week of gestation this hormone showed a constant increase. Possible explanations for the differences between the induced and physiological cycles are discussed.