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AN ASSESSMENT OF URINARY AND PLASMA STEROID ESTIMATIONS FOR MONITORING TREATMENT OF ANOVULATION WITH GONADOTROPHINS

Total urinary oestrogens (UE), plasma oestradiol‐17β (PE2), plasma progesterone and urinary pregnanediol values were estimated during 28 cycles of treatment with human menopausal gonadotrophins (HMG) and human chorionic gonadotrophin (HCG) in seven patients with primary or secondary amenorrhoea who complained of infertility. Ovulation occurred in 23 courses of treatment and three patients became pregnant. PE2 estimations gave a more accurate day to day assessment of the response of patients to treatment than UE values. Monitoring of treatment with PE2 values should reduce any tendency to overstimulation with HMG and allow more accurate timing of the first HCG injection which is critical for a successful ovulatory response. The first HCG dose is an effective stimulus to ovulation when administered on the day of the UE peak which is the day after the PE2 peak. The first HCG dose appeared to be an ineffective stimulus to ovulation if given subsequent to this time or more than two days after the last HMG stimulation.