Hormone levels and anogenital swelling of female chimpanzees as a function of estrogen dosage in a combined oral contraceptive

A combined oral contraceptive consisting of ethinyl estradiol (EE2) in three dosages (50, 100, and 400 micrograms) and norethindrone (0.5 mg) was given to female chimpanzees to determine the effect on endogenous sex hormone levels and anogenital swelling. Serum levels of EE2 increased with increasing dosages of EE2, estradiol decreased, and luteinizing hormone, progesterone and testosterone were maintained at approximately midfollicular phase levels. Urinary levels of EE2 glucuronide increased with the increasing dosages of EE2, whereas estrone and pregnanediol glucuronide were essentially undetectable. The cyclic increase in female anogenital swelling was abolished when the norethindrone was combined with 50 micrograms of EE2 and relatively constant and low levels of swelling were recorded. Relatively constant but successively higher levels of swelling were recorded when the norethindrone was combined with the higher dosages of EE2. These effects of oral contraceptives on female genital tissues are relevant to our laboratory studies of sexual behavior in chimpanzees given oral contraceptives and could also have implications for women taking oral contraceptives.

Idiometric assay, the third way: a noncompetitive immunoassay for small molecules

A novel, noncompetitive immunoassay applicable to the measurement of small molecules including ovarian steroids is described. Using monoclonal antibodies with the ability to recognize both beta-typic and alpha-typic binding sites, a new simplified, sensitive, and specific immunoassay system has been developed. The initial work of this development is presented, along with preliminary results for a novel immunoassay for estradiol.

Hirsutism: metabolic effects of two commonly used oral contraceptives and spironolactone

Fifty-one hirsute women were randomly treated for nine months with ethinyl estradiol 35 ug plus norethindrone 0.4 mg or 30 ug ethinyl estradiol plus 1.5 mg norethindrone acetate if they needed contraception or spironolactone 200 mg daily if they did not. Metabolic evaluations in response to therapy demonstrated triglyceride elevations with the two oral contraceptives but not with spironolactone. While systolic blood pressure was lower with spironolactone, fasting insulin levels were higher as opposed to either low-dose oral contraceptive preparation. Ethinyl estradiol 30 ug plus 1.5 mg norethindrone acetate lowered 3-alpha-diol glucuronide levels, yet ethinyl estradiol 35 ug plus norethindrone 0.4 mg and spironolactone were more effective in lowering Ferriman-Gallwey Scores. Treatment strategies for hirsute women need to consider metabolic consequences as well as efficacy.

Ovarian response in superovulated cycles after suppression with oral contraceptive steroids

The endocrine response to controlled ovarian hyperstimulation was reviewed in 94 women undergoing in vitro fertilization during 114 cycles. The purpose of this review was to evaluate the effect of short-term oral contraceptive suppression on the recovery of pituitary gonadotropin function and subsequent controlled ovarian hyperstimulation. Seventy-three cycles (64%) were adequate for oocyte retrieval. In 41 cycles (36%) hyperstimulation was discontinued. The serum 17 beta-estradiol value in women with a poor response was 57 +/- 50 pg/ml on day 8 compared with 376 +/- 334 pg/ml in the women who completed in vitro fertilization (p less than 0.05). The majority of women (84.2%) had a prompt response to controlled ovarian hyperstimulation after short-term oral contraceptive suppression. Most discontinuations were due to dominant follicle selection or luteinizing hormone surge and not to oversuppression by short-term oral contraceptives. Clinical pregnancies occurred in 15 women (20.5% of harvests).

Seminal estrone, estrone sulfate, and estradiol-17 beta levels in fertile and infertile males

The seminal levels of estrone (E1), estrone sulphate (E1S), and estradiol-17 beta (E2) were measured simultaneously after a chromatographic step in the semen samples of 79 men, including fertile volunteers, vasectomized subjects, and patients with oligozoospermia and secretory azoospermia. E1S concentrations in seminal plasma were higher than in serum (with a semen/serum ratio of approximately 2). Seminal E1 and E1S levels in oligozoospermic subjects were significantly decreased compared to controls (p less than 0.02 and p less than 0.03, respectively). The seminal E1S concentration was significantly reduced in azoospermic patients (p less than 0.02) and to a greater extent in vasectomized subjects (p less than 0.001). As seminal E1S is likely to be mainly of testicular origin, the decreased seminal E1S levels in oligoazoospermia are an index of impaired testicular function.

Pharmacokinetics of oestrogens and progestogens

There are large inter- and intra-individual variations in the serum concentrations of natural and synthetic sex steroids irrespective of the route of administration. Oral ingestion of steroids has a stronger effect on hepatic metabolism than parenteral administration, as the local concentration in liver sinusoids are 4-5 times higher during the first liver passage. Oestradiol and oestrone are interconvertible, dependent on the local concentrations in liver and target organs, and oestrone sulphate serves as a large reservoir. The oestrone/oestradiol ratio has no physiological significance, as oestrone is only a weak oestrogen. Oestrone is both a precursor and a metabolite of oestradiol. Oestriol is extensively conjugated after oral administration. Therefore, the oestriol serum levels are similar after oral intake of 10 mg and after vaginal application of 0.5 mg oestriol resulting in similar systemic effectiveness. Conjugated oestrogens can easily enter the hepatocytes but are hormonally active only after hydrolyzation into the parent steroids. Ethinylestradiol which exerts strong effects on hepatic metabolism and inhibits metabolizing enzymes, should not be used for hormone replacement therapy. Among the progestogens, the progesterone derivatives have less effects on liver metabolism than the norethisterone derivatives (13-methyl-gonanes and 13-ethyl-gonanes). The highly potent 13-ethyl-gonanes are effective at very low doses, because of a slow inactivation and elimination rate due to the ethinyl group.

Lack of effect of vasectomy on peripheral gonadotrophin and steroid levels

In order to re-assess the possible hormonal consequences of male sterilization, the peripheral plasma levels of lutropin (LH) follitropin (FSH), and dihydrotestosterone sulphate (DHT-S) were measured in a group of 20 healthy men at weekly intervals in the month before and at bimonthly intervals up to 2 years after vasectomy. In addition, the levels of 14 steroids of gonadal and/or adrenal origin were measured before, and then every second month (12 subjects) or every sixth month (8 subjects) following vasectomy. No significant alterations were observed in the levels of any of the hormones studied. The results are interpreted as indicating that in the first 2 years following vasectomy in men there is no consistent or progressive change in the peripheral plasma levels of gonadotrophins or in a variety of steroids of testicular and/or adrenocortical origin.

Effect of vasectomy on the steroid profile of human seminal plasma

The effect of vasectomy on the steroid profile of seminal plasma was studied in 19 healthy men at 4-monthly intervals during a 2-year post-vasectomy period. The steroids analyzed by radioimmunoassays were: androstenedione (A), testosterone (T), dihydrotestosterone (DHT), oestradiol (E2) and the sulphoconjugated forms of pregnenolone (delta 5P-S), dehydroepiandrosterone (DHEA-S), testosterone (T-S), dihydrotestosterone (DHT-S), oestrone (E1-S) and oestradiol (E2-S). The quantitatively most important steroids present in the seminal plasma were DHEA-S, delta 5P-S and DHT-S. Vasectomy resulted in a significant but non-progressive reduction in DHT (40%) and T (23%) levels. The levels of E2, delta 5P-S and DHT-S also exhibited a smaller reduction following vasectomy. No significant changes were observed in the levels of the other steroids studied. The results are interpreted as suggesting that under normal conditions the bulk of the steroids present in the ejaculate is contributed by the accessory reproductive organs. In addition, a significant part of the DHT and T reach the ejaculate together with the sperm directly from the testis and/or epididymis. It is suggested that the normal steroid levels in seminal plasma established in this investigation could serve as reference values in the hormonal evaluation of male infertility.

An intrauterine progesterone contraceptive system (52 mg) used in pre- and peri-menopausal patients with endometrial hyperplasia

An intrauterine progesterone contraceptive system (IPCS) (52 mg) was inserted in 25 women with cystic endometrial hyperplasia. Among these women, 11 complained of heavy climacteric symptoms and also received an oestrogen replacement therapy consisting of conjugated oestrogens (0.625 mg/day) administered cyclically for 3 out of 4 wk. Prior to the therapy and after 6 mth of treatment, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), oestrone (E1) and oestradiol (E2) plasma levels were measured and endometrial histology was evaluated. In the women receiving IPCS treatment alone, there were no significant changes in FSH, LH, PRL, E1 and E2 plasma levels. However, there were remarkable changes found in their endometrial histology. In the remaining women receiving both treatments there was a sharp decrease in FSH and LH plasma levels and an increase in E1 and E2 plasma levels, while the prolactin levels remained unchanged. With the exception of two of these women, the endometrial histology changed remarkably. The endometrial morphology of the two exceptions remained unchanged. All climacteric symptoms disappeared after the administration of both IPCS and the oestrogen replacement therapy. The remarkable changes which did occur in the endometrial histology resulted in a less active glandular epithelium and stromal decidual formation, thus proving a useful effect of treatment.

Plasma levels of medroxyprogesterone acetate (MPA), sex-hormone binding globulin, gonadal steroids, gonadotrophins and prolactin in women during long-term use of depo-MPA (Depo-Provera) as a contraceptive agent

The aim of the study was to evaluate the functional state of the hypothalamo-pituitary-gonadal axis and to assess the concentrations of MPA in the peripheral blood during very long-term use of depo-medroxyprogesterone acetate (DMPA) as a contraceptive agent. The concentrations of MPA, sex-hormone binding globulin (SHBG) and the different pituitary and gonadal hormones in the peripheral blood were measured in nine 26-41 year old women. They had for 4.4-10.6 years (mean 8.9 years) been receiving DMPA im in a dose of 150 mg every 12th week as a contraceptive. Blood samples were obtained immediately before an injection of DMPA, 2 weeks later, and again immediately before the next injection. SHBG was measured by radio-electro-immunoassay; MPA, gonadal and pituitary hormones by RIA. The investigation showed that the oestradiol levels - even after very long-term use of DMPA - were still within the normal range for the early follicular phase. Gonadotrophins and prolactin were within the normal range for eumenorrhoeic women as well as the concentration of SHBG. MPA did not accumulate in the plasma. The changes in the plasma levels of oestradiol, MPA and SHBG after each injection disappeared within 12 weeks. The study appearts to warrant the conclusion that even up to 10 years' use of DMPA in a dose of 150 mg im every 12th week as a contraceptive agent, does not induce hormonal changes different from those seen after the very first injection.

Sex hormone levels and intestinal absorption of estradiol and D-norgestrel in women following bypass surgery for morbid obesity

A report of reduced serum levels of progestins, following oral administration after jejunoileal bypass, promoted the present investigation of the absorption of D-norgestrel and estradiol following different types of intestinal bypass surgery for morbid obesity. A group of non-operated obese patients served as control. Apart from significantly higher gonadotrophin levels, which could be attributed to periovulatory sampling in the non-operated group, there was no significant differences in basal levels of estradiol, estrone, conjugated estrone, androstendione, testosterone, and progesterone. The operation did not influence the pattern of the menstrual cycle. Following a single oral dose of 4 mg micronized estradiol and 125 microgram D-norgestrel, serum levels of estradiol and estrone were equal in the three groups. serum D-norgestrel was equal in the two operated groups, but was significantly higher in the bypass group with 1:3 jejunoileal ratio, compared with the non-operated group. Further, a significant negative correlation between peak levels and weight was found. It is suggested that one year following bypass surgery, obesity - but not intestinal bypass - might be associated with reduced serum levels of exogenous sex steroids following oral administration.

Plasma concentrations of oestrone, oestradiol, oestriol and progesterone during mechanical stretch-induced abortion at mid-trimester

Plasma levels of unconjugated oestrone, oestradiol, oestriol and progesterone were serially studied in six uncomplicated patients in the mid-trimester of pregnancy before and during abortion induced by purely mechanical stretching of the uterus by laminaria and rubber balloon. Variability of these hormonal levels among patients was significant before the treatment. In four cases where the fetus was aborted alive, the plasma value of these hormones remained at a high level during the treatment with the exception of oestriol level in one case. In two early mid-trimester cases the fetus died during the treatment and plasma oestriol dropped significantly, while the level of the other hormones remained raised until fetal delivery. In these two cases the apparent onset of labour was noted before fetal death. It was concluded that the onset and progress of labour by mechanical stretching of the uterus is probably unrelated to the steroid hormones estimated in the present study.

[The determination of unconjugated estrone, estradiol, estriol and estetrol in serum or amniotic fluid by high performance liquid chromatography with an amperometric detector (author's transl)]

A simultaneous microdetermination of unconjugated estrone, estradiol, estriol and estetrol in serum or amniotic fluid by High Performance Liquid Chromatography with an Amperometric Detector is described. Steroids in serum or amniotic fluid were extracted with 10 volumes of ethyl ether, and then ether extract was evaporated to dryness under N2 gas. After defatting with a mixture of 50% methanol/n-hexane, the methanol phase was evaporated to dryness under N2 gas. The residue was applied to microcolumn packed with 2 ml volume of Sephadex LH-20 in the eluting solvent benzene/methanol (85:15). Fractions contained estrone and estradiol; estriol and estetrol were collected and then evaporated to dryness under N2 gas. The sample solution was applied to HPLC using a reverse phase ODS column and acetonitrile: 0.1M KH2 PO4 47:53 for estrone and estradiol fraction, and 30:70 for estriol and estetrol fraction as a mobile phase, respectively. The fraction of each estrogen was separated completely within a 20 minute period. The limit of detection of estrone, estradiol, estriol and estetrol was 50 pg, respectively.

Studies on ovarian and adrenal steroids at different phases of the menstrual cycle. 1. Dynamic changes during the periovulatory period

In order to assess the periovulatory interrelationships between the plasma levels of estradiol, estrone, 17-hydroxyprogesterone, progesterone, cortisol and biologically active lutropin (LH), peripheral blood samples withdrawn from 12 normally menstruating women at 07.00, 15.00 and 23.00 h. during seven days of the midcycle period were analyzed. The estradiol peak varied between 0.86 and 1.50 nmol/l; it preceded the LH peak in 11 subjects and occurred simultaneously with it in 1 case. Although the peak levels of estradiol were significantly higher than those associated with the LH peak, there was no significant difference between the estradiol levels at the LH peak and those found during the 32-hour period prior to the LH peak. Calculation of the estradiol to estrone ratios revealed the existence of two groups of subjects with significantly different ratios. In one group the estradiol levels were significantly lower and those of estrone significantly higher than in the other group. No difference was found between these two groups concerning the other hormonal indices measured. No significant variation was found in the estradiol, estrone and LH levels during the day; however, there was a significant overnight increase in their levels during 3 to 4 days preceding the day of the LH peak. A significant rise in 17-hydroxyprogesterone levels occurred 8 h. before the earliest rise in LH and progesterone levels; on the other hand, in none of the subjects did the first rise in progesterone levels precede the first significant elevation of LH levels.

Steroid hormone accumulation in human breast cyst fluid

Elevated concentrations of peptide hormones have been described previously in human breast fluid. In the current study, the levels of cortisol, progesterone, testosterone, dihydrotestosterone, androsterone, androsterone sulfate, dehydroisoandrosterone, dehydroisoandrosterone sulfate, estradiol, estrone, estradiol sulfate, and estrone sulfate were measured. The levels of the four 17-ketosteroids and the two estrogen sulfates were markedly elevated over the plasma level, while that of the other compounds was the same or only slightly higher than the plasma levels of the same compounds.

A comparison of the pharmacokinetic properties of three estradiol esters

In order to assess the pharmacokinetics properties of estradiol cypionate, valerate and benzoate, the daily plasma levels of estradiol and estrone were analysed in groups of 10, 9 and 10 subjects, respectively, before and during 3 weeks after the intramuscular administration of a single dose of 5.0 mg in 1.0 ml arachis oil. In order to minimize the contribution of endogenous estrogens to the plasma levels, all subjects were receiving a combined oral contraceptive consisting of levonorgestrel (150 micrograms) and ethinyl estradiol (30 micrograms) for three months prior to the study and during the study period. The administration of estradiol cypionate gave significantly lower peak levels of estradiol and estrone than that of the valerate and benzoate. Peak plasma levels of estradiol and estrone were reached in approximately 4 days following the administration of estradiol cypionate and in a significantly shorter time (approximately 2 days) following the administration of both the valerate and benzoate. One hour after the injection of the esters, the average percentage increases in plasma estradiol and estrone levels were significantly higher in the valerate and benzoate groups compared to the subjects receiving estradiol cypionate. The average duration of elevated estrogen levels was shortest in the benzoate group (4-5 days) followed by the valerate (7-8 days) and cypionate (approximately 11 days). In none of the subjects studied were elevated estradiol and/or estrone levels encountered 2 weeks after the injection of the various esters. The data suggests that among the three esters studied, the valerate provides the most predictable pharmacokinetic behaviour.

Socioeconomic status, urine estrogens, and breast cancer risk

Urine estrogens were measured in 46 women students, ages 15-18, at a middle-class high school in Athens and in 40 women of the same age residing at one of three orphanages in the same city. The lower socioeconomic status (SES) of the latter group was documented by their lower mean height (by 5.2 cm) and weight (by 5.3 kg) relative to the high school students. Both in follicular and luteal phases of the menstrual cycle, the women with lower SES had 50% higher estriol ratios (ratio of the concentration of estriol to the sum of the concentrations of estrone and estradiol). In luteal specimens the concentration of all three major estrogens was higher in the group with low SES than in the women in the other group, but the concentration of estriol was most increased. There was also an indication of less frequent anovular cycles among the women with low SES. These findings are consistent with hypotheses linking either the estriol ratio or the frequency of anovular cycles to breast cancer risk.

Hyperprolactinemia in cases of infertility and amenorrhea

Of 17 patients with longstanding (3--15 years, mean 7.7 years) amenorrhea and hyperprolactinemia, 8 developed their amenorrhea after the use of oral contraceptives (Group I) and 9 became amenorrhoic spontaneously (Group II). There were no differences between the groups with respect to the basal serum levels of FSH, LH, low polar estrogens (estradiol-17 beta + estrone) and prolactin. Tomography revealed pituitary adenoma in four patients. One of these developed symptoms of her tumor during pregnancy; the symptoms disappeared after delivery. The other patients with tumors are checked twice a year and have not yet received any treatment. The patients with no detectable tumors were treated with bromocriptine starting with 1.25 X 3 daily. The peripheral serum levels of prolactin, FSH, LH, low polar estrogens and progesterone were determined once a week and if the prolactin levels remained high, the bromocriptine dose was increased. All these patients started to menstruate as soon as prolactin returned to normal levels (below 25 micrograms/l). All patients who wished to became pregnant, i.e. 6 patients. Three were delivered by cesarean section, one had a normal delivery and two are still pregnant. There was no difference between Group I and Group II in the dose required or in the duration of treatment before menstruation started. Three cases of galactorrhea were found.

Pharmacokinetic studies on low dose estradiol 17 beta administered orally to postmenopausal women

Peripheral plasma from four postmenopausal women was analysed for estrone, estradiol, lutenizing hormone and follicle stimulating hormone during 24 hours following an oral intake of a single dose of 1.0 mg micronized estradiol, on the first day of therapy and after one month. A similar study was carried out with another four postmenopausal patients, who received 0.2 mg estradiol three times daily. The measurements were performed by radioimmunoassay (RIA). It is concluded that the plasma concentrations of estrone and estradiol are higher and those of FSH lower after one month of therapy than on the first treatment day, while plasma LH remains unchanged. Micronized estradiol is rapidly absorbed from the gastrointestinal tract and converted to estrone, and the plasma profiles of estrone during the day are more constant with a divided daily dose than with a single higher dose. The divided daily dose results in an equally good clinical effect even though the total administration of estradiol is lower.

Adrenal steroids and the development of osteoporosis in oophorectomised women

To explore the possibility that the wide variation in bone loss among oophorectomised women might be due to differences in adrenal androgens or their biosynthetic pathways, 18 women (10 with very fast and 8 with very slow bone loss) were selected. Serum levels of nine adrenal steroids, including the major androgens and cortisol, were measured under basal conditions and after overnight suppression followed by acute corticotropin stimulation. In addition, basal serum oestrone, oestradiol, dehydroepiandrosterone sulphate, sex-hormone-binding-globulin, corticosteroid binding globulin, and urinary free cortisol were measured. The only significant differences found were that women who lost bone rapidly had significantly higher urinary free-cortisol excretion (p less than 0.001) and a paradoxically diminished cortisol response to corticotropin. These data make it unlikely that endogenous adrenal androgens or oestrogens are a major factor in preventing bone loss after cessation of ovarian function; cortisol by its catabolic effect, however, may be a significant factor in causing osteoporosis.

Hormonal profiles in lactating and non-lactating women immediately after delivery and their relationship to breast engorgement

Prolactin, human placental lactogen (HPL), oestrone, oestradiol and progesterone levels in plasma were measured before and during the first seven days after delivery in women who did not breast feed. The results confirmed the rapid clearance of placental steroids from the circulation after delivery. Plasma prolactin levels remained elevated during the early puerperium and the range of values were the same in non breast-feeding women and a group of breast feeding women. Of the 25 women studied, six developed breast engorgement. No difference in hormonal profiles were found leading to the conclusion that there is no endocrine basis for breast engorgement in non-breast feeding women.

Estrogen profiles in young women: effect of maternal history of breast cancer

To examine the hypothesis that familial breast cancer risk is related to estrogen metabolism, we analyzed urines of daughters of breast cancer patients and their matched controls for estrone (E1), estradiol (E2), and estriol (E3). From this, we computed estriol proportions (E3/E1 + E2 + E3). "Patient-daughters" and the matched controls showed no differences in estriol proportions. Our results failed to support the hypothesis that high-risk women (those with a family history of breast cancer) have relatively lower estriol proportions, and we concluded that whatever family history contributes to breast cancer risk, that risk is not likely to be transmitted by the estrogen profile.

Comparison of serum oestrogen concentrations in post-menopausal women taking oestrone sulphate and oestradiol

Mean serum concentrations of oestradiol-17beta, oestrone, and oestrone sulphate in postmenopausal women were the same when measured up to six hours after treatment with either piperazine oestrone sulphate 1.5 mg or oestradiol valerate 2 mg. Maximum concentrations of oestradiol were less than those of oestrone, but oestrone sulphate reached concentrations about 30 times higher than those of oestrone. The rapid conversion of oestradiol valerate to oestrone and oestrone sulphate does not support the suggestion that in menopausal women oestradiol is less likely to be associated with a risk of endometrial carcinoma than oestrone sulphate, since the two preparations appear to become identical after ingestion.

15alpha-Hydroxyoestriol and other polar oestrogens in pregnancy monitoring

Although oestriol measurements are well established for the assessment of 'at risk' pregnancies, there are a number of other oestrogens, excreted during pregnancy, which contain additional hydroxyl groups and might be more sensitive indicators of the condition of mother or fetus. Some of these result from the action of hydroxylases possibly present only in the fetus and others from maternal hydroxylations. We review the evidence for the biosynthesis of these polar oestrogens, summarise methods of measurement, and compare values obtained in normal and pathological pregnancies. There is as yet insufficient evidence to enable their potential value to be confirmed.

Androstenedione metabolism in patients with endometrial cancer

The plasma concentration of androstenedione and the instantaneous conversion of androstenedione to estrone was increased in patients with endometrial cancer as compared to postmenopausal control subjects. Moreover, the per cent of estrone derived from androstenedione was increased in the cancer group.

Steroid and prostaglandin concentrations in the plasma of pregnant ewes during infusion of adrenocorticotrophin or dexamethasone to intact or hypophysectomized foetuses

Catheters were implanted into 16 ewes and their foetuses between days 110 and 124 of gestation. Hypophysectomy was attempted in eight of these foetuses. Continuous infusion of synthetic ACTH (10 microgram/h) or dexamethasone (1mg/24 h) into the foetus, starting between days 124 and 129, induced premature parturition. The concentration of progesterone in the maternal peripheral plasma decreased before parturition in all animals while the level of oestradiol increased in ewes with intact foetuses or in those in which hypophysectomy was incomplete. When hypophysectomy was complete, no increase in the maternal level of oestradiol occurred before delivery. The concentration of 13,14-dihydro-15-oxo-prostaglandin F2alpha increased in the peripheral plasma of ewes with intact or hypophysectomized foetuses infused with ACTH. It is suggested that an intact foetal pituitary gland is required for the rise in the level of oestrogen prepartum, but that this rise is not essential for increased prostaglandin production of parturition.

A direct radioimmunoassay for estriol-16-glucuronide in urine for monitoring pregnancy and induction of ovulation

Antibodies to estriol-16alpha-[beta-D-glucuronide] were raised in sheep with the use of keyhold limpet hemocyanin and bovine serum albumin conjugates of estriol-16alpha-[beta-D-glucuronide]. A simple, rapid method is presented for direct radioimmunoassay of estriol-16alpha-[beta-D-glucuronide] in urine with dextran-coated charcoal used for separation of free from bound and deionized water used for dilutions. The method is thrifty in its use of reagents. The assay has been evaluated in the pregnancy range, and the sensitivity has been extended into the range necessary for monitoring induction of ovulation with Pergonal.

[Diagnosis and monitoring of endangered early pregnancies with determination of oestrone, oestradiol 17beta, oestriol, progesterone and HPL in plasma and the pregnancy test in graduated dilutions of urine (author's transl)]

Unconjugated oestrone (Oe1), oestradiol-17beta (Oe2), oestriol (Oe3), progesterone (P) and HPL in plasma were determined by radioimmunoassay and the immunological pregnancy-test in urine was carried out in 70 patients with normal pregnancy or imminent abortion from 4th-20th week of gestation. Oe2 and HPL showed the most pronounced rises, Oe3 increased especially after the first trimester. In cases with abortion symptoms and poor prognosis Oe2 and HPL gave the most reliable results concerning the endocrin function of early normal pregnancy. Oe1- and P-values in normal pregnancy did not differ so clearly from concentrations observed during normal menstrual cycles and were thus of less value. The pregnancy-test was positive (greater than 1000 IU/1) even in most cases of dead pregnancy and therefore not reliable. With increasing production of oestrogen precursors in the fetal adrenal cortex after the first trimester determination of Oe3 becomes more important. In cases with abortion symptoms in early pregnancy and subsequent normal development, plasma Oe2- and Oe3- values represented best criteria for a prognosis. -- For the diagnosis and control of the endangered early pregnancy we recommend, as a consequence of this study, determination of Oe2 up to the 13th week of pregnancy and thereafter Oe3 in maternal plasma.

Studies on the pattern of circulating steroids in the normal menstrual cycle. 4. Periovulatory changes in relation to the LH surge

By the use of a non-thrombogenic pump, blood was withdrawn continuously at a rate of 4.0 ml/h over a period of 48 h from 10 normally menstruating women during various phases of the peri-ovulatory period and the integrated levels of oestradiol, oestrone, 17-hydroxyprogesterone, progesterone, 20α-dihydroprogesterone and biologically active luteinizing hormone (LH) were estimated in 3-hourly plasma collections.

The first significant change detected two days prior to the LH surge (day LH-2) in one subject studied during this period was a continuous parallel rise in oestradiol and oestrone levels, which occurred in the absence of any simultaneous change in LH and 17-hydroxyprogesterone levels.

Marked fluctuations followed by a sudden drop in oestradiol levels were observed in another woman during the day preceding the LH peak (day LH-1). These changes were not associated with similar alterations in oestrone levels. The marked drop in oestradiol coincided with the beginning of a simultaneous major rise in LH and 17-hydroxyprogesterone levels followed some 6 to 9 h later by a small but significant increase in progesterone levels.

The period of the LH surge (day LH) was studied in 3 women. This period was characterised by a constant decline in oestradiol levels in the presence of unchanged oestrone values. The decrease in oestradiol levels preceded the LH peak by at least 12 h. The LH peak was biphasic in all subjects; both the ascending and descending limbs of it were significantly correlated to similarly changing levels of 17-hydroxyprogesterone. The increase in these two hormones preceded that in progesterone levels, which occurred later, at the time of the steepest rise in LH levels. The findings of the subsequent day (day LH+1) were characterised in two subjects by a parallel decrease in plasma oestradiol, LH and 17-hydroxyprogesterone levels, until a plateau was reached. This plateau coincided with a new rise in progesterone and 20α-dihydroprogesterone levels.

The hormonal profile observed two days following the LH surge (day LH + 2) in 3 women was similar to that of the preceding day, with the exception of a beginning new rise in 17-hydroxyprogesterone levels by the end of day LH + 2. This second rise in 17-hydroxyprogesterone paralleled that in progesterone and 20α-dihydroprogesterone levels and occurred in the presence of decreasing levels of LH.

The data reported strongly suggest that different control mechanisms are involved in the regulation of ovarian steroid secretion during the various phases of the peri-ovulatory period.

Urinary oestrogen excretion, oestrous behaviour and ovulation in heifers treated with prednisolone during pro-oestrus and oestrus

The purpose of the trial was to investigate the effect of prednisolone treatment during pro-oestrus and oestrus on the ovarian function in heifers. Four heifers were treated daily with 30 mg prednisolone i.m. per 100 kg body weight from pro-oestrus until ovulation was palpated. Treatment with prednisolone did not appear to have any effect on the length of the follicular phase or on ovulation. In three of the treated heifers, the urinary excretion of oestrous behaviour was normal but in the remaining heifer the excretion of oestrogen was found to be lower and oestrous behaviour weakly expressed. The effects of corticosteroids on the follicular phase, ovulation and oestrous behaviour in different species are discussed.

[Concentration of estrone, estradiol and estriol in the blood of pregnant sheep after induction of estrus with chlormadinone acetate and medroxyprogesterone acetate]

The radioisotopic method of 131J-labelled albumin was employed to determine the distribution of acidic proteinase activity in some organs and tissues of chickens. The highest enzymatic activities were found in intestine wall, in pancreas, and in liver. Considerably lower activities were ascertained in kidneys, brain, lungs, and heart. The different proportions of these enzymes in homogenates and supernatant fractions (106 000 g) testify to a lack of uniformity in the solubility of cathepsins in the organs tested. The tested organs, with the exception of pancreas, did not show any enzymatic activity of neutral proteinases.

[Effect of gestagen therapy upon estradiol- and progesterone-receptor-level and 17beta-hydroxysteroid dehydrogenase in human endometrial adenocarcinoma (author's transl)]

Oestradiol was converted to oestrone about ten time more rapidly by subcellular fractions of normal human endometrium of the secretory phase than by tissue of the proliferative phase. In subcellular fractions of endometrial carcinoma the 17beta-hydroxysteroid dehydrogenase (17beta-HSD) activity decreased with decreasing differentiation of the tumour. Most of the 17beta-HSD activity was located in mitochondrial and microsomal fractions of both normal and neoplastic endometrium. After treatment of patients with gestagens only the well differentiated carcinomata significantly increased in 17beta-HSD activity demonstrating that the hormonal stimulus leads to similar effects on the 17beta-HSD activity as in normal endometrium. Furthermore quantitative aspects of the in vitro binding of 3H-oestradiol and 3H-progesterone to receptor components from normal endometrium and endometrial carcinoma cytoplasmic fractions have been studied. In normal tissue the number of cytoplasmic binding sites for both oestradiol and progesterone varied dramatically during the menstrual cycle: number of oestradiol binding sites were highest during the proliferative phase and fell during the secretory phase; for progesterone site the contrary was the case. In all endometrial carcinomata high oestradiol binding activity was observed. In contrast the number of progesterone sites in the tumours was related to the state of differentiation, which paralled the progestional sensitivity of these tumours.

[Preovulatory changes of steroidogenesis in isolated rabbit follicles (author's transl)]

In an attempt to investigate the effect of ovulating hormone on the steroidogenesis of mature follicles in the course of ovulation, transitory changes of steroidogenesis in isolated rabbit follicles have been studied at several intervals after injection of an ovulatory dose of human chorionic gonadotropin (hCG). Five to ten follicles of approximately 1-2 mm in diameter were isolated from ovaries of a mature rabbit (2.5-3.0 kg) under streomicroscope, before and at the 3rd, 6th, 9th and 12th hours after intravenous injection of of 100 IU/kg of hCG. Follicles were incubated with 100 muCi of acetate-1-14C in 2 ml of Krebs-Ringer bicarbonate buffer (pH 7.4) at 37 degrees C for 3 hours under 95% oxygen plus 5% carbon dioxide. Each incubation was terminated by quick freezing and stored forzen at -20 degrees C until eighty follicles had been collected for each time period before commencement of analysis. Incorporation of radioactive acetate into pregnenolone, 17-hydroxypregnenolone, progesterone, 17-hydroxyprogesterone., 20 alpha-dihydroxyprogesterone, dehydroepiandrosterone, androstenedione, testosterone, estrone and estradiol-17beta were analysed by the reverse dilution technique and identified in radiochemically pure form by recrystallization to constant specific activities. The steroidogenic activity of the follicles was evaluated by overall as well as fractionated incorporations. A peak in the overall incorporation of 14C- acetate into the ten steroids at the 3rd hour after hCG injection, followed by gradual decrease up to the 9th hour was observed. The incorporation decreased markedly to a minimum level at the 12th hour after hCG injection, which was below the level of preinjection control. Comparable quantitative fluctuations were found with the fractionated incorporation of 14C-acetate into the C21 and C18 steroids in the time sequence following hCG injection. However, the fractionated incorporation into C19 steroids reached to a maximum at the 6th hour after hCG injection. 5istribution patterns of incorporation among the individual steroids were varied at each interval of time. In the non-injected control, mature follicles synthesized predominantly estradiol-17beta, testosterone and androstenedione. Divergent steroids were formed from radioactive acetate at the 3rd hour after hCG injection. These included porgestogen, androgen and estrogen, but pregnenolone and 17hydroxyprogesterone were the two principal steroids produced. There was no essential difference in the steroidogenic patterns between the 6th and 9th hour, the major products being C21 and C19 steroids such as pregnenolone, 17hydroxyprogesterone, dehydroipiandrosterone and testosterone. The three androgens were the major steroids formed at the 12th hour after hCG injection. Thus the chages in the steroidogenic profile of the follicle was obvious in the course of ovulation. The basis of qualitative changes in follicular steroidogenesis during the process of ovulation have been discussed in connection with an accompanying effect of an ovulatory dose of hCG.