Single and repeated GnRH agonist stimulation tests compared with basal markers of ovarian reserve in the prediction of outcome in IVF

PURPOSE

To study the value of a single or repeated GnRH agonist stimulation test (GAST) in predicting outcome in IVF compared to basal ovarian reserve tests.

METHODS

A total of 57 women was included. In a cycle prior to the IVF treatment, on day 3, an antral follicle count (AFC) was performed and blood taken for basal FSH, inhibin B and E2 measurements, followed by a subcutaneous injection of 100 microg triptorelin for the purpose of the GAST. Twenty-four hours later blood sampling was repeated. All the tests were repeated in a subsequent cycle. From the GAST E2 and inhibin B response were used as test parameters. The outcome measures were poor ovarian response and ongoing pregnancy. Group comparisons were done using the Mann-Whitney or chi-square test. Univariate and multivariate logistic regression was applied to assess which test revealed the highest predictive accuracy as expressed in the area under receiver-operating characteristic curve (ROC(AUC)). Clinical value was compared by calculating classical test characteristics for the best logistic models.

RESULTS

All the basal and GAST variables were significantly different in the poor responders (n = 19) compared to normal responders (n = 38). In the univariate analysis on cycle 1 tests the AFC was the best predictor for poor ovarian response, while in cycle 2 the E2 response in the GAST performed best (ROC(AUC) of 0.91 for both). Multivariate analysis of the basal variables led to the selection of AFC and inhibin B in cycle 1, yielding a ROC(AUC) of 0.96. Mean E2 response was selected in a multivariate analysis of the repeated GAST variables (ROC(AUC) 0.91). At a specificity level of -0.90, several logistic models including GAST variables appeared to have a sensitivity (-0.80), positive predictive value (-0.82) and false positive rate (-0.18), comparable to a logistic model containing AFC and inhibin B. None of the test variables showed a significant relation with ongoing pregnancy.

CONCLUSIONS

The GAST has a rather good ability to predict poor response in IVF. However, comparing the predictive accuracy and clinical value of the GAST with a day 3 AFC and inhibin B, it appeared that neither a single nor a repeated GAST performed better. In addition, the predictive ability towards ongoing pregnancy is poor. Therefore, the use of the GAST as a predictor of outcome in IVF should not be advocated.

Effects of combined sex hormone replacement therapy on small artery biomechanics in pharmacologically ovariectomized rats

OBJECTIVES

The purpose of this study was to determine the effects of long-term combined sexual hormone replacement therapy on the biomechanical properties of the small artery wall in castrated female rats.

METHODS

30 non-pregnant mature female Sprague-Dawley rats were pharmacologically ovariectomized with 750 microg/kg triptorelin im. every 4th week. Ten of them received combined hormone replacement in form of 15 mg/kg medroxyprogesterone acetate (MPA) im. every 2 weeks and 450 microg/kg estradiol propionate im. once a week. Ten castrated animals received MPA only. Ten control, castrated animals were given the vehicles of these steroids. Ten other animals were kept parallelly, receiving the vehicles of all drugs (control animals). After 12 weeks of treatment cylindrical segments of the saphenous artery were isolated and cannulated at both ends and subjected to in vitro microarteriographic test. Pressure diameter curves, in the range of 0-200 mmHg, were recorded from segments in normal Krebs-Ringer (nKR) solution, in contraction with norepinephrine (1.6 x 10(-5) M), and then in relaxation with papaverine (2.8 x 10(-5) M). Biomechanical parameters were calculated based on the pressure diameter curves.

RESULTS

Combined hormone replacement therapy significantly increased the passive diameter of small arteries, as compared to those from ovariectomized animals without hormone replacement. MPA monotherapy did not alter the vessel diameter, the inner radii at 100 mmHg intraluminal pressure were, 300+/-9 microm in the control castrated, 340+/-7 microm in the estradiol + MPA replaced and 306+/-8 microm in the MPA treated groups (P < 0.05 between the control castrated and the combined treatment groups). The vascular reactivity to norepinephrine or papaverine was not changed significantly either by combined hormone replacement or by MPA monotherapy when compared with ovariectomized controls. No significant alterations were found in wall thickness and distensibility.

CONCLUSIONS

These results suggest that chronic medroxyprogesterone pretreatment does not influence the geometric, elastic and contractile properties of small arteries in castrated female rats. The combination of MPA + estradiol increased the morphological lumen: the morphological vasodilatation induced by estrogen, described earlier, was not affected by the addition of this progestin to the regimen.

The effect of ovariectomy and oestrogen replacement on small artery biomechanics in the rat

OBJECTIVE

To determine the effects of oestrogen deficiency and hormone replacement therapy on the biomechanical properties of a small artery.

SAMPLE

Thirty non-pregnant female Sprague-Dawley rats.

METHODS

Twenty animals were pharmacologically ovariectomised by triptorelin and received either oestradiol propionate or its vehicle. Ten other animals received only the vehicle for the same period of time (control group). After 12 weeks of treatment, cylindrical segments of the saphenous artery were isolated and cannulated at both ends. Pressure-diameter curves were recorded from segments in normal Krebs-Ringer, using norepinephrine, and then with papaverine. The vessel segment close to the examined one was histologically evaluated. Serum levels of oestradiol and cortisol were determined.

MAIN OUTCOME MEASURES

Biomechanical parameters based on the pressure-diameter curves.

RESULTS

Pharmacological ovariectomy decreased the passive diameter of the arteries and oestrogen replacement therapy prevented this. Decreased reactivity to norepinephrine was also restored by oestrogen treatment. Pressure induced myogenic tone was decreased significantly by oophorectomy and increased after oestradiol treatment. No significant changes were found in wall thickness, distensibility, elastic modulus or tangential stress. No significant histological alterations were seen in the vessel wall. Oestradiol levels were significantly decreased in the castrated animals compared with the other two groups.

CONCLUSIONS

These results suggest that oestrogen deficiency decreases and oestrogen replacement increases the passive diameter of small peripheral arteries, and that oestrogen enhances the reactivity of vascular smooth muscle. These responses may provide the background mechanisms for the increased incidence of arterial hypertension and hot flushes during the menopause and the ability of oestrogen substitution to prevent them.

Births after transcervical gamete intrafallopian transfer with a falloposcopic delivery system

OBJECTIVE

To evaluate the safety and efficiency of a new delivery system to perform transcervical GIFT.

DESIGN

Evaluation of pregnancy rate (PR), miscarriage rate, ectopic pregnancy rate, and delivery rate.

SETTING

Institute of Obstetrics and Gynecology, Reproductive Endocrinology Unit, Infertility and IVF Center.

PATIENT(S)

Twenty-five patients with patent tubes documented by laparoscopy plus falloposcopy.

INTERVENTION(S)

Superovulation was induced with GnRH analogue and FSH. Under laparoscopic control, transcervical cannulation of the tube was done using a linear everting catheter incorporating direct falloposcopic vision of the tubal lumen. Two lengths of everting catheter (3 and 6 cm) were used providing either isthmic-ampullary or midampullary placement of the inoculum. A comparison was done in terms of ease of access and transfer, falloposcopic observations, and PRs between the groups.

MAIN OUTCOME MEASURE(S)

Efficacy was established by evaluating the PR, miscarriage rate, ectopic pregnancy rate, and delivery rate.

RESULT(S)

The PR was 28% (with no differences between the lengths of everting catheters). No ectopic pregnancies occurred. The abortion rate was 28.6% and the delivery rate was 20%. Neither tubal perforation nor other complications occurred during the procedure.

CONCLUSION(S)

Falloposcopic GIFT is safe and efficient and may be a less invasive alternative than laparoscopic transfer.

A study of the luteolytic mechanism of the antiprogesterone RU486 during the late-luteal phase in pseudopregnant rats

The purpose of this study was to examine the possible mechanism through which RU486 induces luteolysis during the late-luteal phase in pseudopregnant (PSP) rats. PSP rats received a subcutaneous injection of RU486 in sesame oil (5 mg/kg body weight) or sesame oil alone once a day between day 9 and day 11 of pseudopregnancy. Serial blood samples were collected on days 5, 9, 10, 11 and 12 and assayed for progesterone content. To examine the possible action of RU486 through a uterine and/or a pituitary (prolactin-dependent) mechanism, PSP rats and chronic hysterectomized PSP rats which had been hysterectomized before PSP induction received a subcutaneous injection of RU486 in sesame oil (5 mg/kg body weight), sesame oil alone, prolactin in 50% polyvinylpyrrolidone (15 IU/day), or RU486 and prolactin once a day between day 9 and day 11 of pseudopregnancy. Serial blood samples were collected on days 5, 9, 10 and 11 and assayed for progesterone content. Blood samples were also collected at 0400 h on day 12 and used for prolactin and progesterone determinations. To examine the direct effect of RU486 on corpus luteum and/or pituitary, hysterectomized rats underwent hypophysectomy and pituitary autotransplantation on dioestrus 1 and received a subcutaneous injection of RU486 in sesame oil or sesame oil alone for 3 days between day 21 and day 23 after surgery. Serial blood samples were collected on days 10, 21, 22, 23 and 24 and assayed for progesterone and prolactin contents. In ordinary PSP rats, serum progesterone levels were significantly (P < 0.01) lower in the RU486-treated group than in the control group (9 +/- 1 vs 53 +/- 7 ng/ml; mean +/- S.E.M.) on day 11. Serum prolactin levels at 0400 h on day 12 of pseudopregnancy were significantly (P < 0.05) lower in the RU486-treated group than in the control group (16 +/- 4 vs 154 +/- 44 ng/ml; mean +/- S.E.M.). The concomitant prolactin treatment reversed the luteolytic effects of RU486 on day 11 of pseudopregnancy. In hysterectomized PSP rats, RU486 also suppressed serum prolactin levels, and the concomitant prolactin treatment again reversed the luteolytic effects of RU486. In hysterectomized rats which were hypophysectomized and pituitary autotransplanted, RU486 treatment did not induce any significant changes in serum progesterone and prolactin levels. These results indicated that RU486 induced luteolysis during the late-luteal phase in PSP rats by suppressing prolactin secretion via a hypothalamic mechanism.

The comparison of early follicular and midluteal administration of long-acting gonadotropin-releasing hormone agonist

Long-acting GnRH-a (D-Trp6 microcapsules, 3.2 mg) was intramuscularly injected, either in early follicular phase (group A) or midluteal phase (group B). Two hundred sixteen cycles were randomly allocated. Ovarian suppression was significantly more prompt in group B. Follicle cysts were diagnosed in 19% and 16% of groups A and B, respectively; their appearance and regression were significantly more rapid in group B cycles. More ampules of human menopausal gonadotropin were needed in group B. The number of oocytes retrieved was not significantly different between the groups. However, in group A more mature oocytes and more embryos with good morphology were achieved in the patients. Cancellation rate was 2.8% in groups A and B. Pregnancy rate and outcome were similar in both groups.

Correlation between follicular fluid content and the results of in vitro fertilization and embryo transfer. III. Proteoglycans

Using a specific proteoglycan (PG) radioimmunoassay (RIA) in which human cartilage antiserum was directed against the PG protein core, the PG content of follicular fluid (FF) obtained from 42 women undergoing in vitro fertilization (IVF) and embryo transfer (ET) was studied as a function of IVF-ET outcome. Inhibition curves of purified PG cartilage preparations were parallel to those of large and small nonstimulated follicles and follicles that had been stimulated by a luteinizing hormone-releasing hormone (LHRH) agonist, d-tryptophan-6 (Decapeptyl: D-Trp6 analogue, Beaufour Laboratories, IPSEN Biotech, Paris, France), and human menopausal gonadotropin (hMG). While FF levels of immunoreactive PG-like material (Ir-PG) did not differ according to IVF-ET outcome, highly significant negative correlations were obtained between FF 17 beta-estradiol levels and FF Ir-PG levels in oocyte groups where pregnancy was obtained, i.e., oocytes were fertilized and cleaved, and pregnancy followed either for each ET or for one of two embryos reimplanted. The correlation persisted but weakened when all groups were pooled together. No correlation was observed between FF Ir-PG and progesterone. RIA or bioassay showed a positive correlation between FF inhibin and Ir-PG for the group in which each ET led to a pregnancy. Ir-PG concentrations were significantly greater in smaller than in larger follicles collected from untreated women. Upon induction of ovulation with either pure follicle-stimulating hormone (FSH), FSH + human chorionic gonadotropin (hCG), or D-Trp6/hMG + hCG, this difference no longer appeared. These results indicate that the reduction of Ir-PG concentrations constitutes an index of follicular maturation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of precocious puberty with an LH-RH agonist (D-TRP6-LH-RH)]

Chronic administration of luteinizing hormone-releasing hormone (LH-RH) is currently considered as the most appropriate therapy of precocious puberty. A delayed release preparation of D-Trp-6-LH-RH (Décapeptyl in microcapsules) designed to release the agonist for 28 days after intramuscular injection of 60 micrograms/kg body wt was given to 12 boys and 26 girls with precocious puberty. Plasma levels of gonadotropins and sex steroids were suppressed to prepubertal levels within 3 weeks, whilst pituitary responses to LH-RH test were almost abolished within 7 weeks. A significant improvement of secondary sex characteristics, as well as gonadal size, was observed within 6 months. Growth velocity (cm/yr, mean +/- SD) was reduced in boys and girls from 9.9 +/- 3.4 and 9.6 +/- 3.3 respectively before treatment to 5.2 +/- 1.0 and 5.3 +/- 1.3 respectively during the third year of treatment. The mean ratio height age/bone age was just before treatment 0.91 in boys and 0.88 in girls and increased to 1 after 3 yr of treatment. This study shows that Décapeptyl in microcapsules induced a prolonged suppression of gonadal function and a relative blockade of bone maturation. A significant improvement of adult height relative to the effect of conventional treatments should be expected.

[Studies on anordrin injection for termination of early pregnancy in mice]

In order to increase the effectiveness on the termination of early pregnancy, anordrin injection was prepared. A nonaqueous solvent was selected as the parenteral solvent which was not irritating and toxic. The security test showed the injection was also not irritating and toxic. After the injection was heated for 76 h in 95 +/- 2 degrees C water or stored for 3 mon at 37 degrees C, the content of anordrin showed no change. The activation energy of the injection was 68.1 kJ/mol determined by thermogravimeter analysis. This also showed that the injection was steady. Results of termination of early pregnancy in mice showed that a single dose of anordrin injection (3 mg/kg) intraperitoneally was more effective than a single dose of anordrin tablet (3 mg/kg) orally (P less than 0.01). Histological studies showed that embryo, decidual cells and nutrient cells were markedly degenerated or dead when treated with the injection (3 mg/kg) intraperitoneally.

[Effects of prostaglandin F2 alpha on steroidogenesis of the PMSG-hCG primed rat ovary in luteolysis]

Activities of the steroidogenic enzymes involved in functional luteolysis and PGF2 alpha induced luteolysis were determined in PMSG-hCG primed immature rats to elucidate the luteolytic effects of PGF2 alpha. Plasma progesterone (P4), plasma 20 alpha dihydroprogesterone (20 alpha OHP4), in vitro production of pregnenolone (P5) from endogenous cholesterol in ovarian mitochondria (8,000 X g pellet; Mt), activities of 3 beta hydroxysteroid dehydrogenase (3 beta HSD) in ovarian microsome (105,000 X g pellet; Ms) and 20 alpha hydroxysteroid dehydrogenase (20 alpha HSD) in ovarian cytosol(105,000 X g supernatant; Sup) were determined. For the investigation of intramitochondrial transport of cholesterol, measurement of free cholesterol (FCh) of Mt and the Lineweaver-Burk plotting for cholesterol side-chain cleavage enzyme (CSCC), prepared by osmotic shock and sonication of Mt, were carried out. Functional life span of the rat corpus luteum was estimated as 12 days post hCG treatment from plasma P4. As plasma P4 decreased, concomitant increase in plasma 20 alpha OHP4 was observed. In vitro production of P5 in Mt correlated well with plasma P4 levels, indicating cholesterol side-chain cleavage reaction is the rate limiting step involved in ovarian steroidogenesis. In contrast, both values of Km and Vmax of CSCC did not change between day 7, on which the highest value of plasma P4 observed, and day 12, on which functional luteolysis was ascertained from plasma P4. Both FCh of Mt and the activity of 3 beta HSD in Ms remained unchanged during the functional life of the corpus luteum. The activity of 20 alpha HSD in Sup increased from day 10 post hCG treatment in accordance with plasma 20 alpha OHP4. These results indicate that 1) decrease in availability of FCh to CSCC within mitochondria and 2) increase in catabolism of P4 into inactive progestin, 20 alpha OHP4, may play key roles in the functional luteolysis. To compare the events observed in functional luteolysis with PGF2 alpha induced luteolysis, the animals were treated either with PGF2 alpha (1 mg/rat; s.c.), cycloheximide (5 mg/rat; i.p.; CX), or vehicle on day 7 post hCG treatment, and sacrificed 1 hour later for the analyses mentioned above. Both plasma P4 and in vitro production of P5 in Mt decreased significantly with PGF2 alpha or CX treatment, whereas the FCh of Mt and the activity of CSCC remained unchanged with PGF2 alpha treatment. Both plasma 20 alpha OHP4 and 20 alpha HSD in Sup increased with PGF2 alpha treatment. However, CX suppressed both of them.(ABSTRACT TRUNCATED AT 400 WORDS)

Luteolytic potency of 16-phenoxy-derivatives of prostaglandin F2 alpha

The binding of 16-phenoxy derivatives of prostaglandin (PG) F2 alpha to rat luteal membranes, and also their abortifacient potency in pregnant rats, have been studied. Competitive binding studies with various PG-analogues were performed in ovaries of juvenile rats pretreated with PMSG and HCG, and in parallel studies the abortifacient potency of these substances was tested in pregnant rats. It was observed that this class of derivatives bound to the PGF2 alpha receptor as well as, or even better than the parent compound PGF2 alpha. Modifications in the carboxyl group at C-1 yielded derivatives with a higher affinity for the receptor, in decreasing order of effectiveness as follows: -COOR greater than COOH greater than OH. The data obtained from the binding studies also compared well with data on the abortifacient potency in pregnant rats. It is concluded that the addition of a phenoxy group to either the lower or upper side chain of PGF2 alpha may augment the binding to the receptor as well as the biological responses induced by the post receptor effect.

Effect of estradiol-17 beta on peripheral plasma concentration of 15-keto-13,14-dihydro PGF2 alpha and luteolysis in cyclic cattle

Friesian heifers (n = 10) were assigned randomly to receive an intravenous injection of estradiol-17 beta (E2; 3 mg) or saline:ethanol vehicle solution (6 ml; 1:1) on day 13 of the estrous cycle. Blood was collected from the jugular vein by venipuncture into heparinized vacutainer tubes at 30 minute intervals for 2 hours (h) preinjection, 10.5 h postinjection and then at 3 h intervals until estrus. Repeated hormone measurements of 15-keto-13,14-dihydro-PGF2 alpha (PGFM) and progesterone (P4) were evaluated by split-plot analysis of variance. Mean concentration of PGFM for the 12.5 h acute sampling phase was 164.1 +/- .14 pg/ml. A treatment by time interaction was detected (P less than .01). After treatment with E2, PGFM concentrations began to increase at approximately 3.5 h, reached a mean peak of 330.4 +/- 44.5 pg/ml (n = 5) at 5.5 +/- .3 h, and returned to basal concentration by 9.0 +/- .6 h. Vehicle treatment did not alter concentrations of PGFM. Injection of E2 on day 13 of the estrous cycle caused luteolysis (P4 concentration less than 1 ng/ml) to occur earlier following injection (96.9 +/- 10.6 h less than 153.6 +/- 17.7 h; P less than 0.05) than did the vehicle control treatment. During the chronic sampling phase of 3 h intervals, 39 of 606 samples (6.4%) were classified as PGFM spikes (323.0 +/- 50.0 pg/ml); 21 (53%) of the spikes occurred at a mean interval of 18.9 +/- 3.86 h before the time of completed luteolysis. Exogenous E2 induced an acute increase in PGFM that may be indicative of uterine PGF2 alpha production. Peaks of PGFM in plasma were temporally associated with luteolysis on a within cow basis.

Ectopic pregnancy among early abortion patients: does prostaglandin reduce the incidence?

The availability and efficacy of prostaglandin (PG) F2 alpha and E series analogues has prompted their frequent use for pregnancy interruption. In the course of evaluating our experience with PGs for interrupting early first trimester gestations, we became increasingly impressed by the absence of any with extrauterine pregnancy. A review of 63 reports encompassing 2,965 patients whose pregnancies were less than 8 weeks' gestational age dating from the last menstrual period and who were similarly treated yielded only 2 cases of ectopic pregnancy. When compared with the generally accepted ectopic gestation rates of the order of 1 in 200 pregnancies, this frequency of 1 in 1,483 is unexpectedly low. Preselection does not appear to explain this impressive discrepancy. If the observation proves correct, it implies that PGs have some form of therapeutic effect in eradicating extrauterine pregnancy by nonoperative means. The implications are obvious in terms of its potential therapeutic benefits.

Effects of prostaglandin E1 (PGE1) on estradiol-17 beta induced luteolysis in the nonpregnant ewe

Nonpregnant ewes were assigned as they came into estrus to one of the following randomized treatment groups: 1) Vehicle (1 ml corn oil) + Vehicle (buffer), 2) Estradiol-17 beta + Vehicle (buffer) or Estradiol-17 beta + PGE1 in buffer. Ewes were unilaterally ovariectomized on day 8 postestrus and an intrauterine cannula was installed in the uterine horn adjacent to the remaining luteal-bearing ovary. Buffer of PGE 1 (500 micrograms) in buffer was infused intrauterine every 4 hours from day 8 through day 15. Luteolysis was initiated by giving an intramuscular injection of estradiol-17 beta (500 micrograms) on days 9 and 10. Chronic intrauterine infusions of PGE1 maintained jugular progesterone through day 15 and weights of corpora lutea and progesterone in corpora lutea on day 15 although luteolysis was initiated by estradiol. It is concluded that chronic intrauterine infusions of PGE1 can prevent an estrogen-induced premature luteolysis.

Oxytocin is luteolytic in the rhesus monkey (Macaca mulatta)

Oxytocin (10 mi.u./microliter/h) or vehicle (0.5% chlorobutanol in saline, 1 microliter/h) was chronically infused directly into the corpus luteum of normally cyclic rhesus monkeys, by means of an Alzet pump-ovarian cannula system. Infusion of oxytocin (N = 6) or vehicle (N = 5) began 6 days after the preovulatory oestradiol surge, and daily peripheral blood samples were taken. Oxytocin caused a significant (P less than 0.05) decrease in progesterone, beginning 1 day after treatment, and oestradiol after 4 days; progesterone and oestradiol remained significantly depressed until menstruation. However, peripheral LH concentrations remained unchanged. The duration of the luteal phase, menstrual cycle and the onset of menses from the initiation of oxytocin infusion were significantly (P less than 0.01) shorter when compared to those of vehicle-treated controls. These results show that oxytocin can induce functional luteolysis in the primate and supports the hypothesis that oxytocin of luteal origin may play a role in spontaneous luteolysis.

Prostaglandin therapeutics in the bitch and queen

The use of prostaglandin F2 alpha as an abortifacient and for the treatment of certain diseases affecting the reproductive system of the bitch and queen is reviewed. Doses of 0.5 to 1.0 mg/kg PGF administered by intramuscular or subcutaneous injection at intervals of 24 or 48 h after mid-gestation appears to be a satisfactory luteolytic-- abortifacient regime for use in dogs and cats. Doses of 0.25 to 0.5 mg/kg in the bitch and 0.5 to 1.0 mg/kg PGF in the queen, at intervals of 24 or 48 h, may be used as an adjunct to the therapy of metritis, endometritis or pyometritis. A median lethal dose of 5.13 mg/kg has been derived for use of PGF in the bitch and this is thought to be similar for use of PGF in the queen. Side effects of defecation and/or vomition may be observed in the bitch and queen using routine therapeutic doses.

Studies on equine prematurity 2: Post natal adrenocortical activity in relation to plasma adrenocorticotrophic hormone and catecholamine levels in term and premature foals

Adrenocortical and medullary function was investigated during the immediate post natal period in premature and full term foals. High plasma cortisol concentrations were characteristic of the term foals in the first 2 h after birth and these were accompanied by significant arteriovenous differences in plasma cortisol across the umbilical circulation at birth, indicating enhanced adrenal activity before delivery. No such arteriovenous differences were detected in the premature group and post natal changes in plasma cortisol were minimal. The apparent inability of the premature foal adrenal to secrete cortisol was not due to the lack of endogenous adrenocorticotrophic hormone (ACTH) because high levels of this hormone were found immediately after birth in both groups of foals. Tests on the sensitivity of the foal adrenal to exogenous ACTH1-24 (0.125 mg intramuscularly [im]) showed that a maximum response to this hormone could be elicited in term foals on the day of birth. Subsequently basal cortisol levels and the response of the adrenal to ACTH1-24 declined. By contrast, only a slight response was observed following the same dose of ACTH1-24 in the premature group. Exposure to Depot ACTH1-24 over 24 h enhanced the basal secretion of cortisol in both premature and term foals but no consistent response to the same ACTH test dose could be elicited in the former. A wide range of total plasma catecholamine concentrations was observed in both groups of newborn foals. The highest values were seen in acidotic animals and there was a significant inverse relationship between blood pH and total plasma catecholamine level at delivery.(ABSTRACT TRUNCATED AT 250 WORDS)

Preliminary studies of mammary secretions in the mare to assess foetal readiness for birth

The status of the mare and foetus in relation to readiness for birth was assessed by measurement of the electrolytes sodium, potassium and calcium in mammary secretions pre-partum. Sixteen Thoroughbred mares were allowed to foal spontaneously and the ionic status of their mammary secretions was measured over three to five weeks pre-partum. From these measurements, a scoring system was developed where an ionic score of 35 points or more suggested that the mare was within 24 h of foaling. On the basis of this ionic score, 10 pony mares were induced with either oxytocin or fluprostenol and assessment of foal maturity was made by physical, behavioural and physiological criteria. Eight pony mares, induced when the ionic score was 35 points or more, delivered full term foals; two mares were induced when their scores were 30 and 20 points and delivered a full term and slightly immature foal respectively. These results suggest that foetal maturity may be related to electrolyte concentrations in mammary secretions and that an ionic score of 35 points or more may indicate that induction would be successful in terms of maturity of the newborn foal.

Studies on equine prematurity 1: Methodology

This paper describes the general management of mares and foals during the perinatal period and the methodology used in a collaborative research project on equine prematurity. Sixteen mares with dated pregnancies delivered 45 foals over three breeding seasons (1981 to 1983). In the majority, parturition was induced with oxytocin and/or fluprostenol; the remainder were allowed to foal spontaneously. Pre-colostral milk analysis provided a means of assessing the pre-foaling status of the mare. All were observed and monitored before, during and after parturition and the sampling protocol for both mare and newborn foal is discussed in detail. The foals were assessed for their degree of maturity at birth using behavioural, haematological, acid-base status and other criteria; they were then assigned to groups for further study and tests.

Intracranial haemorrhage in pre-viable, premature and full term foals

A neuropathological examination was carried out on the brains of 58 foals. Forty-two were pony foals induced at various periods of gestation from 200 days onwards. Two were pre-viable pony foals delivered by caesarean section and 14 were Thoroughbred foals (one set of twins, two stillborn, five premature, two dysmature, two convulsive and one induced). The only significant pathological change involved intracranial haemorrhage. Subarachnoid haemorrhage occurred in all of 10 pony foals induced before 301 days of gestation and in two pony foals born by caesarean section at 270 and 280 days gestation. Subarachnoid haemorrhage was also present in some pony and Thoroughbred foals born after 301 days gestation; the incidence usually appeared greater in those pony foals which survived for the shortest periods. Haemorrhage also occurred elsewhere in the brains, including the cerebral white matter, the molecular layer of the cerebellum and the medulla, but the intensity could not be related to either length of gestation or duration of survival. No other neuropathological changes were found that could account for the functional state of the animals, whether they were pre-viable, premature, dysmature or convulsive.

Studies on equine prematurity 4: Effect of salt and water loss on the renin-angiotensin-aldosterone system in the newborn foal

Plasma renin substrate concentration was measured in 18, four-day-old pony foals after the administration of the natriuretic agent frusemide. Thirteen foals had been delivered spontaneously; labour had been induced in the remaining five mares. Plasma aldosterone concentration was measured in 12 of the spontaneously delivered foals. Renin substrate concentration had risen sharply within 15 mins (P less than 0.005) and peaked at 1 h. The response was consistently greater in the induced foals. Serum sodium concentration fell rapidly in the induced foals (P less than 0.002 by 60 mins) but was better maintained in the spontaneous group. Individual serum potassium concentrations varied widely and were higher in both the induced group and smaller (30 kg or less) spontaneous foals. Plasma renin substrate concentration was positively correlated with plasma potassium in both groups (P less than 0.05, P less than 0.001 respectively). Plasma aldosterone rose significantly within 30 mins (P less than 0.025) and did not stabilise during the experiment. Plasma aldosterone was significantly correlated with renin substrate concentration in both lighter (P less than 0.005) and heavier (P less than 0.05) spontaneously delivered foals. It is suggested that maturation of renal sodium and potassium handling occurs late in gestation in the foal and is in part related to body mass. 'Premature' delivery following induced labour is associated with a more rapid loss of sodium when challenged with frusemide, even though the response of the renin-angiotensin system may be exaggerated.

Studies on equine prematurity 3: Insulin secretion in the foal during the perinatal period

The factors influencing beta cell function in the foetal and neonatal foal have been investigated in chronically catheterised foetal foals and in newborn foals delivered either spontaneously at term or by induction at different gestational ages. Insulin was detected in the foetal plasma from as early as 150 days of gestation (term = 340 days) and during the last third of gestation the foetal beta cells responded to exogenous administration of glucose and arginine and to endogenous variations in the glucose level. Insulin secretion by the foetal beta cells was depressed by anaesthesia and surgery. At birth, there was a significant positive correlation between the plasma concentrations of insulin and glucose irrespective of the maturity at birth or type of delivery (r = 0.86, n = 39, P less than 0.01). The slope of this relationship was significantly less than that relating the postoperative foetal concentration but only when delivery was difficult or prolonged was the beta cell sensitivity to glucose completely abolished. At birth, there were no significant differences in the plasma concentrations of insulin or glucose between full term foals delivered spontaneously or by induction. However, the spontaneously delivered foals showed a transient increase in the insulin concentration 15 mins after birth which was not observed in the full term foals delivered by induction. Plasma glucose concentrations were maintained during the 2 h after birth in the absence of sucking in both the induced and the spontaneously delivered full term foals. Premature foals had significantly lower plasma glucose concentrations at birth than full term foals.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of prostaglandin F2 alpha and its synthesis inhibitor indomethacin on corporaluteal functions in pseudopregnant rats

The effects of PGF2 alpha and its synthesis inhibitor indomethacin on corporaluteal (CL) functions were studied in adult pseudopregnant rats. The CL functions were assessed by studying the duration of pseudopregnancy and histological changes in the ovary. Administration of PGF2 alpha (4 mg/kg BW) significantly (P less than 0.001) shortened the duration of pseudopregnancy. Histological examination of ovaries revealed regressed CL. Administration of indomethacin, on the other hand, significantly (P less than 0.001) prolonged the duration of pseudopregnancy. Histological examination of ovaries revealed large and well formed CL, the diameters of which were significantly (P less than 0.05) increased. Administration of indomethacin and PGF2 alpha simultaneously, however, keeps the duration of pseudopregnancy within normal limit. Further, the shortening in the duration of pseudopregnancy by PGF2 alpha alone was completely reversed by exogenous administration of progesterone. Since PGF2 alpha shortens and indomethacin (an inhibitor of PGF2 alpha synthesis) prolongs the duration of pseudopregnancy, it is concluded that PGF2 alpha acts as a luteolytic agent in rats. The mechanism of luteolysis is most likely to be due to decrease plasma progesterone level. An estimation of blood progesterone level after administration of PGF2 alpha to pseudopregnant rats is therefore, suggested.

Uterine stimulant action of some omega-chain modified (+)-11-deoxyprostaglandins

Rat uterine stimulant activity has been determined in vivo for a series of (+)-11-deoxyprostaglandins. The most active members of the series. 11-deoxy-15 methyl-PGE1, 11-deoxy-16,16-dimethyl - PGE1 and its 1-alcohol were 2-3 times more potent than PGE1. Gastrointestinal side effects assessed by the antagonism of morphine-induced constipation in the mouse, were generally relatively low with these compounds and consequently several members of the series had a more favourable relative selectivity than 16,16-dimethyl-PGE2 methyl ester.

Luteolytic effect of D-Trp6-luteinizing hormone-releasing hormone in the rhesus monkey (Macaca mulatta)

A potent agonist of luteinizing hormone, D-Trp6-LRH, was administered at different stages during the luteal phase of rhesus monkeys (Macaca mulatta). Luteolysis, evidenced by short luteal phases and decreased serum progesterone concentrations, was consistently induced when the analog was injected on days 3 or 5 post ovulation; however, no effect was observed when it was given on day 7 post ovulation. Increasing doses of hCG administered from days 6-10 post ovulation prevented the luteolytic effect of D-Trp6-LRH. The possible mechanisms of action and the potential uses of LRH analogs as contraceptive agents are discussed.

Chorionic gonadotropin prevents LRF-agonist-induced luteolysis in the human

The effects of exogenous and endogenous hCG on the luteolytic action of LRF-agonist, [D-Trp6, Pro9NEt]-LRF (LRF-Ag), were evaluated. In sequential studies, 4 normal cycling women treated with LRF-Ag (50 microgram S.C.) on two consecutive days had premature decline of circulating levels of progesterone (P) and estradiol (E2) with a shortened (p < 0.05) luteal phase (11.5 +/- 1.2 days) when compared to the control cycle (15 +/- 0.7 days). When intramuscular hCG was added to the LRF-Ag treatment in doses of 100 IU or 5000 IU daily for 7 days, the luteal function was prolonged (19 +/- 1.2 days, p < 0.05) with significant (p < 0.001) elevation of P and E2 levels compared with the control cycle. Four women with early pregnancy, requesting therapeutic abortion, were given LRF-Ag (50 microgram or 500 microgram S.C.) on 2 consecutive days. None of the 4 women aborted and there was no change in the levels of beta hCG, P or E2 over the course of a week. These results indicate that both exogenous or endogenous hCG can overcome the luteolytic effect of LRF-Ag within the dose and duration used. The possibility that a more prolonged administration of a larger dose of LRF-Ag may negate the luteotropic effect of hCG remains to be explored.

Synthesis and antifertility activity of omega-chain phenyl- and 16-phenoxy-analogues of (+/-)-11-deoxyprostaglandin F1 alpha

Some omega-chain phenyl- and 16-phenoxy- analogues of (+/-)-11-deoxyprostaglandin F1 alpha have been synthesized and evaluated for anti-fertility activity in the hamster. 11-Deoxy-16-phenoxy-17,18,19,20-tetranor-PGF1 alpha was the most active member of the series with an ED50 equal to that of PGF2 alpha. 11-Deoxy-17-phenyl-18,19,20-trinor-PGF1 alpha, which was one third as active as PGF2 alpha, was more potent than the corresponding 16- and 18-phenyl compounds. Aryl ring substitution was found to lower activity, except that with the 16-phenyl compound, p-bromo and m-trifluoromethyl substitution increased the potency. The antifertility activity of the phenoxy compounds, which were poor substrates for 15-hydroxyprostaglandin dehydrogenase, was shown to correlate well with the binding affinity for the bovine corpus luteum PGF2 alpha receptor. Some quantitative structure-activity data supporting this finding are presented.

Prostaglandin in milk, days open, and estrus detection in dairy cows treated with prostaglandin F2 alpha

Prostaglandin F2 alpha was used to induce estrus in postpartum dairy cows to decrease calving interval and time spent on heat checks. The amount of prostaglandin residue in milk after treatment also was investigated. Twenty-two control cows, checked for heat twice daily, were bred at estrus after 55 days postpartum. Sixty-three cows checked on days 55 to 60 were either bred if in estrus or treated with 30 mg of prostaglandin F2 alpha injected intramuscularly on day 60 and bred at induced estrus or at 75 h posttreatment. Twelve cows were in heat between days 55 and 60 and were bred. Twenty-nine of 51 treated cows were seen in estrus; all of these were bred and 51.7% conceived at this time. Treated cows had fewer days to first service than did controls, but days open were not different, 105.7 versus 101.8. Fertility was similar. Controls required more heat checks than did treated cows (39 to 8.2). Milk from 17 cows at two milkings before and ten milkings after treatment had similar concentrations of prostaglandin (698 +/- 27 pg/ml) except for the first posttreatment milking when prostaglandin concentration almost doubled (1.293 +/- 143 pg/ml).

Corpus luteum susceptibility to prostaglandin F2 alpha (PGF2 alpha) luteolysis in hysterectomized prepuberal and mature gilts

The susceptibility of induced corpora lutea (CL) of prepuberal gilts and spontaneously formed CL of mature gilts to prostaglandin F2 alpha (PGF2 alpha) luteolysis was studied. Prepuberal gilts (120 to 130 days of age) were induced to ovulate with Pregnant Mare Serum Gonadotropin and Human Chorionic Gonadotropin (HCG). The day following HCG was designated as Day 0. Mature gilts which had displayed two or more estrous cycles of 18 to 22 days were used (onset of estrus = Day 0). Gilts were laparotomized on Day 6 to 9, their CL marked with sterile charcoal and totally hysterectomized. On Day 20, gilts were injected IM with either distilled water (DW), 2.5 mg PGF2 alpha or 5.0 mg PGF2 alpha. An additional group of prepuberal gilts was injected with 1.25 mg PGF2 alpha, a dose of PGF2 alpha equivalent, on a per kilogram body weight basis, to the 2.5 mg PGF2 alpha dose given to the mature gilts. The percentages of luteal regression on Day 27 to 30 for mature and prepuberal gilts given DW, 2.5 mg PGF2 alpha and 5.0 mg PGF2 alpha were 0.0 vs 4.4, 43.5 vs 96.8 and 47.7 vs 91.6, respectively; the percentage of luteal regression for the prepuberal gilts given 1.25 mg PGF2 alpha was 75.1. These results indicate that induced CL of the prepuberal gilt were more susceptible to PGF2 alpha luteolysis than spontaneously formed CL of the mature gilt and that pregnancy failure in the prepuberal gilt could be due to increased susceptibility of induced CL to the natural luteolysin.

Effects of PGE1 or PGE2 on luteal function in pseudopregnant rats

Effects of PGE1 or PGE2 on luteal function were studied in 163 pseudopregnant rats. PGE1 (10, 100, or 300 micrograms) given intrauterine every 6 hr did not shorten pseudopregnancy (P greater than 0.05), however, the same doses of PGE2 given intrauterine every 6 hr advanced luteolysis (P less than 0.05). PGE1 (100 or 300 micrograms) given every 4 hr intramuscular maintained levels of progesterone in peripheral blood above controls (P less than 0.05) while 100 or 300 micrograms of PGE2 hastened the decline in progesterone (P less than 0.05). The antiluteolytic effect of PGE1 was not via an inhibition of PGF secretion (P greater than 0.05) by the uterus or by induction of ovulation in treated animals. Moreover, PGE1 (100, 200, or 500 micrograms) given intramuscular every 4 hr from day 4 of pseudopregnancy until the next proestrus delayed luteal regression around 3 days (P less than 0.05). PGE2 at doses of 100, 200, or 500 micrograms every 4 hr given intramuscular consistently shortened pseudopregnancy (P less than 0.05). Lower doses were without effect (P greater than 0.05). Based on the above data it is concluded that PGE2 is consistently luteolytic whereas PGE1 is not luteolytic in pseudopregnant rats and that PGE1 may be an antiluteolysin.

Termination of pseudopregnancy in rats by silastic-PVP-PGF2 alpha tube

The efficacy of a one-end or both-end open Silastic-polyvinyl-pyrrolidone (Silastic-PVP) tube containing 600 microgram prostaglandin-F2 alpha (PGF2 alpha) and placed subcutaneously on day-6 of pseudopregnancy (PSP) in the induction of premature termination of PSP was compared. A both-end open Silastic-PVP-PGF2 alpha tube was more efficacious in inducing an early termination of PSP with a mean duration of 7.8 days. By contrast, PSP females receiving a one-end open Silastic-PVP-PGF2 alpha tube showed a mean duration of PSP of 9.9 days. The shortened duration of PSP in both these treatment groups was significantly different from the control value of 13.1 days. The significant drop in progesterone (delta 4P) but rise in 20 alpha-dihydroprogesterone (20 alpha-DHP) occurred 24 hr after treatment in PSP rats treated with both-end open Silastic-PVP-PGF2 alpha tube, whereas similar changes in delta 4P and 20 alpha-DHP took place 48-72 hr after the deposition of a one-end open Silastic-PVP PGF2 alpha tube. It is concluded than an initial larger amount of circulating PGF2 alpha is needed to induce an early premature termination of PSP. The exposure of corpus luteum to a more sustained but lower level of PGF2 alpha leads to a slower response.

Luteolytic prostaglandins. Synthesis and biological activity

Analogues of PGF2 alpha with enhanced luteolytic activity were synthesized using the Corey synthesis. The luteolytic activity of the new prostaglandins was tested in the hamster. In addition the smooth muscle activity of the new compounds was compared with that of PGA2 on the longitudinal strip of rat stomach fundus. Structure-activity relationships in the new series of 17,18,19,20-tetranor-16-thienyl-oxy-PGF2 alpha are discussed.

Estradiol inhibition of luteinizing hormone-stimulated progesterone synthesis in isolated bovine luteal cells

The effects of several steroid hormones on progesterone synthesis and cAMP accumulation in isolated bovine corpora luteal cells were investigated in an attempt to determine if any of the steroids would affect the basal level of these processes or their response to gonadotropin. Isolated bovine corpora luteal cells responded to LH with a significant (P less than 0.05) increase in progesterone synthesis and cAMP accumulation when incubated at 37 C for up to 1 h. Exogenous cAMP and analogs of cAMP also significantly stimulated steroidogenesis in these incubated cells. Stimulation of progesterone synthesis by 1 microgram/ml LH was significantly suppressed (P less than 0.05) in the presence of 5--10 microgram/ml estradiol. This inhibition appeared to be largely specific for 17beta-estradiol, in that other steroids such as estrone, estriol, 17alpha-estradiol, cortisol, and dihydrotestosterone were not inhibitory. Testosterone was found to be inhibitory, but it is uncertain if this effect was due to the androgen itself or to its conversion to estradiol. Estradiol did not affect the increase in endogenous cAMP caused by LH in these cells, but did inhibit the effect of exogenous dibutyryl cAMP on progesterone synthesis. The magnitude of this inhibition of the effect of dibutyryl cAMP was not, however, equal to the estradiol inhibition of the stimulation of progesterone synthesis by LH. These data indicate that estradiol, a possible physiological luteolytic agent, has a direct inhibitory action on the corpus luteum and produces its suppression by blocking the stimulatory effect of LH at a step after cAMP.

The luteolytic effect of prostaglandin F2alpha on the guinea pig corpus luteum in relation to gonadotropins and stages of the oestrous cycle

When hysterectomized guinea pigs were treated daily with prostaglandin F2α, (0.058 mg PGF2α/100 g body weight per day), luteal volumes and systemic levels of progesterone were unaffected up to day 9 of the oestrous cycle, but the onset of luteolysis had occurred around day 12, 3–4 days earlier than normal. The treatment of hysterectomized animals on days 5–7 and 8–10 at the same dose did not result in luteal regression in any respect on day 14, but treatment on days 9–12 and days 9–13 induced luteolysis. A continuous treatment with 0.135 mg PGF2α/100 g body weight per day reduced the cycle length by 22%, but again luteal volume and progesterone level were unaffected up to day 9. The treatment with human chorionic gonadotropin (50 IU/day) or follicle-stimulating hormone (5 U/day) on days 8–13 had an antagonistic effect on the luteolytic action of PGF2α administered on days 9–13, but prolactin also administered at this time did not have this effect. It is postulated that, in guinea pigs, ovulation and the formation of corpus luteum (CL) are not affected by a low dose of PGF2α, the CL is protected from PGF2α by gonadotropins up to day 9, normal luteolysis is due to the withdrawal of gonadotropins and the upsurge of PGF2α, and the subsequent rate of luteal regression depends on the amount of available PGF2α.

Danazol as a luteolytic agent

Danazol, a synthetic 2,3-isoxazol derivative of 17 alpha-ethinyltestosterone, was administered to healthy nonpregnant volunteers to determine wheter a luteolytic effect could be detected by observation of cycle length, duration of the luteal rise, and luteal steroidogenesis. Danazol administration resulted in a decreased duration of the luteal rise and a decrease in progesterone output in three of four subjects, but no decrease in total cycle length. The administration of human chorionic gonadotropin during danazol administration increased progesterone output. Therefore, danazol would be unlikely to be effective as a luteolytic contraceptive agent.