SYNTHETIC LH-RH AS A THERAPEUTIC AGENT

Abstract

ABSTRACT The present paper describes clinical experiments performed in order to study the therapeutic value of synthetic luteinizing hormone-releasing hormone (LH-RH) in patients with anovulatory sterility. The endocrine state of the patients was defined by the following parameters: Total urinary gonadotrophins, total urinary oestrogens, plasma FSH and LH-levels, plasma oestrogens and plasma progestins. Exclusive administration of 100–200 μg synthetic LH-RH daily for 18–21 days did not result in any ovarian stimulation as determined by plasma oestrogens. HMG-stimulation, however, caused a rapid increase in plasma oestrogen values. In a group of 13 patients with primary or secondary amenorrhoea LH-RH was used for the induction of ovulation after HMG-stimulation. LH-RH was administered by intravenous infusion at a rate of 50 μg/h for 2–8 hours. The LH increase to the pre-ovulatory levels of 50–88 mU/ml was noted in 8 patients, ovulation, however, presumably occurred in only 4 patients. One patient conceived, but the pregnancy was terminated as early abortion. An additional injection of HCG 4 days after the LH-RH infusion resulted in ovulation in one patient as evidenced by subsequent pregnancy. The data presented indicate that synthetic LH-RH is not suitable for the induction of ovulation in HMG-stimulated ovaries. The therapeutic value of LH-RH is probably limited by the responsiveness and capacity of the pituitary.