Monthly administration of the LH-RH analogue decapeptyl for long-term treatment of ovarian dysfunctions and estrogen-dependent disorders

The ovarian function of 11 patients suffering from estrogen-dependent disorders and ovarian dysfunction was suppressed by monthly administrations of an analogue of luteinizing hormone-releasing hormone (LH-RH). During the initial 11 to 18 days of treatment, the LH-RH analogue Decapeptyl was subcutaneously injected daily, followed by intramuscular administration of the peptide encapsulated in biodegradable microspheres at 30-day intervals over a 13- to 35-week period. After an initial increase on day 1 of treatment, serum levels of both LH and FSH declined, but did not reach hypogonadotropic values. The pituitary response in the release of both LH and FSH by a LH-RH bolus injection was almost completely suppressed during the treatment course. 17 beta-Estradiol serum levels decreased into the castration range within 9.1 +/- 4 days and remained low in 92% of the values estimated. In one patient, pretreatment mean testosterone levels on the order of 1.9 ng/mL were suppressed to normal within 14 days and remained low under therapy. Seven out of the 11 patients benefited from this therapy. In conclusion, the treatment with Decapeptyl in a slow-release formulation is an effective and suitable approach for the long-term suppression of ovarian function in estrogen-dependent disorders and ovarian dysfunctions.

Immunoreactive insulin-like growth factor I in human follicular fluid

Recent studies in laboratory animals suggest that insulin-like growth factor I (IGF-I) plays an important role in the regulation of granulosa cell function. The purpose of the present study was to investigate the presence of immunoreactive IGF-I in human follicular fluid (FF) and compare the levels of follicular IGF-I (64 follicles) with those detectable in serum (n = 19) in hyperstimulated cycles from 25 infertile patients. Also, the FF IGF-I levels were correlated to corresponding follicular volume (n = 62) and oocyte maturation (n = 37). Levels of IGF-I were determined using a specific radioimmunoassay after acidification and extraction by reversed phase chromatography. Levels of IGF-I in serum were significantly higher than those in FF (37.1 +/- 10.1 versus 24.0 +/- 9.3 nmol/l, n = 19, P less than 0.001). A positive correlation was found between follicular and serum IGF-I concentrations (r = 0.73). No significant differences were found in FF IGF-I levels derived from follicles of different size or from follicles having oocytes with different grades of maturation. These data indicate that immunoreactive IGF-I is present in human FF in nanomolar concentrations and that FF IGF-I levels correlate with those detectable in serum. The source of FF IGF-I and its regulatory role in humans remains to be elucidated.

Prolactin and gonadotrophin dynamics in response to antagonists of LHRH and dopamine in ovariectomized rhesus monkeys: a dissection of their common secretion

This experiment was designed to study the prolactin (PRL) and gonadotrophin response to an inhibitory analogue of luteinizing hormone releasing hormone (LHRH-A; ORG 30276) and a dopamine antagonist, metoclopramide (MCP), in castrated female rhesus monkeys. The LHRH-A given as an i.v. bolus followed by an infusion 2 h later induced a significant decline in circulating PRL levels reaching a maximum suppression 1 h after initiation of the LHRH-A infusion. Intravenous administration of MCP, performed 1 h after beginning the LHRH-A infusion, resulted in a prompt and abrupt rise in PRL levels in the LHRH-A group as well as in the controls. Luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels showed a progressive decline during LHRH-A treatment. Injection of MCP did not affect the levels of LH and FSH in either of the groups. The data obtained demonstrate in primates that the prolactin inhibitory effect of LHRH-A is easily overcome by the dopamine antagonist, MCP, whereas the LHRH-A-induced gonadotrophin suppression remains unaffected by MCP.

Cyclic administration of an LHRH analogue and of progesterone in risk patients to oral contraceptives

Fifty-five cycles of 9 patients with normogonadotropic ovarian function having risks against oral contraceptives (OCs) and intrauterine devices (IUDs) were treated for contraception with buserelin in a dosage of 300 to 450 micrograms per day i.n. from day 5 to day 26 of the cycles. Additionally, progesterone (P) in a dosage of 75 mg per day was given by intravaginal suppositories from day 20 to day 26 of the cycle followed by a 7-day drug-free interval. Serum levels of LH, FSH and estradiol-17 beta (E2) showed a wide variability. However, most E2 levels were in the early or middle follicular phase range. Mean serum P levels monitored during P replacement were found to be in the secretory phase range. Pattern of menstrual cycles was regular in all patients except one whose menstrual bleedings were already disturbed prior to treatment. This mode of contraception was well accepted, no side effects were observed, no pregnancy occurred. In conclusion, contraception by low-dose intranasal application of buserelin combined with transvaginal P replacement seems to be a useful approach for contraception in patients at risk for both OCs and IUDs.