Endocrine studies in a quintuplet pregnancy.

Abstract

This communication describes a 21 year old patient who developed secondary amenorrhea following the administration of an oral contraceptive Orthe-Novum 2 mg (2 mg norethindrone plus .1 mg mestranol) for 10 months. For the 10 months of administration the patient noted a marked diminution in menstrual flow. After the last cycle of treatment slight bleeding occurred for 2 days and during the next 7 months menstruation did not occur. Tests showed she was not pregnant and bleeding did not occur after giving 10 mg 6-dehydroretroprogesterone per day for 5 days. Admitted to the hospital an attempt was made to induce ovulation by administration of human menopausal gonadotrophin (HMG) (Pergonal) followed by human chorionic gonadotrophin (HCG). This treatment resulted in a quintuplet pregnancy. Clinical and endocrinological findings are reported. Urinary excretion values for estrogens pregnanediol and HCG were abnormally high for the last 5 weeks of pregnancy which terminated at 24 weeks. Placental histology and fetal blood group determinations were conducted in an attempt to establish the zygosity of the fetuses but a definite conclusion on this point could not be drawn.