INDUCTION OF OVULATION WITH HUMAN MENOPAUSAL GONADOTROPINA CASE STUDY WHICH REPORTS CONSIDERABLE VARIATIOP IN SENSITIVITY BETWEEN THE FIRST AND SECOND TREATMENTS

摘要

One patient showed a remarkable change in her sensitivity during separate stages of the human menopausal gonadotropin treatment. The clinical, physical, and hormonal examinations showed low pituitary-gonadal function in this patient. A great amount of human menopausal gonadotropin (HMG 2700 IU) was needed to induce ovulation for the first time. However, in the second treatment, the patient was overstimulated with less than half the amount of HMG used in the first course. A change in ovarian sensitivity to gonadotropin by the previous treatment was suspected for this explanation. In those patients with low pituitary function for a long time, the ovaries may be in a dormant condition. It is supposed that the gonadotropin which was used in the first cycle stimulated the other follicles and prepared them for the next ovulation. The first treatment might have carried its effects to the next one. Autoradiographic methods using the follicles of the mouse ovary showed that follicles of different sizes grow at different rates .6 These facts are also proved hormonally in humans .8 The change in sensitivity after inducing ovulation with HMG may coordinate with these changing follicular growth rates and may suggest real change in ovarian function after the treatment. Better results in the second treatment than the first treatment were also suggesed statistically and in the treatment of hypophysectomized women.910