Three hypogonadal male subjects with very low plasma testosterone levels were given testosterone undecanoate orally (120 mg daily for 3 weeks) as a replacement therapy. Normal adult male testosterone plasma values were rapidly reached and attained throughout the therapy. Similar elevations of plasma androstenedione were noted. A reduction in sex hormone binding globulin following the therapy was observed. Satisfactory clinical responses were reported by the patients. We thank Organon Laboratories Ltd. for supplying TU and financial help with this project.
Seventeen women complaining of infertility (one with primary amenorrhoea, 14 with secondary amenorrhoea, and two with oligomenorrhoea) all had hyperprolactinaemia and were treated with clomiphene citrate and human chorionic gonadotrophin (HCG), and plasma oestradiol, FSH and LH levels were measured. Although adequate pre-ovulatory oestradiol levels were present, the surge of LH was absent until the injection of HCG after which all patients ovulated. There were 12 pregnancies in 9 patients resulting in 10 full-term livebirths, one premature livebirth and one continuing pregnancy. The relevance of these findings to the possible role of prolactin in amenorrhoea is discussed.
SUMMARY The relationship between mid‐luteal plasma levels of progesterone and prolactin was studied in 75 women with regular menstrual cycles. Eighteen women had normal prolactin (mean 260 ± 51.7 mU/l) and normal progesterone levels (mean 67 ± 21.3 nmol/l). Thirty‐nine women had elevated prolactin levels (mean 850 ± 503 mU/l); progesterone levels were normal in all cases (mean 61 ± 22.3nmol/l). Eighteen women had evidence of luteal deficiency (mean progesterone 15.3 ± 7.7 nmol/l); prolactin levels were normal in all cases (mean 243 106 mU/l). There was no correlation between plasma prolactin and progesterone levels.
SummaryTuberculosis of the female genital system is still one of the main causes of infertility in our country. The incidence in Greece was as high as 2.5 per cent of gynaecological patients between the years 1945 and 1953 but dropped to 1.0 and 0.4 per cent during 1953-1962 and 1962-1966 respectively.In 6575 gynaecological operations in our hospital from 1967 to 1976 there were 42 cases of tuberculosis of the genital system, an incidence of 0.64 per cent. Thirty-three were in the reproductive period of life (21-44 years old) and 9 were postmenopausal (ages 48-61). All 42 were married and 35 of them (83 per cent) had never been pregnant. The remaining 7 reported one to three pregnancies in the past. The main reason for admission to hospital is shown in the Table. In our previous work in 1962-1966 primary sterility was a much commoner complaint. Previous extragenital tuberculosis was reported by 8 patients (19 per cent) while another 6 patients gave a more indefinite history. All these patients reported that the primary extragenital tuberculous infection occurred when they were young, before the establishment of regular menstrual cycles. In 1962-1966 a history of extragenital tuberculous infection was commoner (42 per cent); the difference is probably due to the improvement in health services available. The findings on pelvic examination on admission to hospital were negative in 29 patients (69 per cent), ‘fibroids’ in 21 per cent, and ‘adnexal mass’ in 5 per cent. These findings correspond to those in 1962-1968.Tuberculosis was located histologically in the endometrium (17 cases, 40 per cent); in both tubes (10 cases, 24 per cent); in one tube (6 cases, 14 per cent); in both endometrium and endocervix (3 cases); in endometrium and one Tuberculosis of the female genital system. Main complaint on admission to hospital tube (2 cases); in the tube and ovary (1 case); in the endocervix only (1 case) and in the omentum (1 case). This result was similar to that in 1962-1968.Recently, in a group of 28 infertility patients aged 24-32, a sample of fluid was aspirated during laparoscopy from the pouch of Douglas, and endometrial curettings taken during the first day of menstruation were cultured for tuberculosis. None of them had a history of tuberculosis or complained of any symptom besides sterility. Culture of the aspirated fluid from the pouch of Douglas was positive for tuberculosis in 2 (7 per cent). These patients also had positive cultures of endometrial curettings for tuberculosis.