Clinical Effect of Human Urinary Postmenopausal Gonadotropin1

Abstract

A partially purified gonadotropin preparation from postmenopausal urine, Pergonal Batch 22-C, was administered to 6 patients with secondary amenorrhea. Ages ranged from 26 to 36 years. Endocrine investigations did not reveal pituitary, thyroid or adrenal abnormalities. Dosages of Pergonal ranging from 6.8 to 27.2 mg/day alone and/or in combination with a daily dose of 6,000 IU of human chorionic gonadotropin (HCG) were used. Two of the subjects received 2 or 3 courses of treatment. No untoward generalized reactions were noted; local reactions, such as redness and pain at the injection site and an elevation of basal body temperature, were noted in 4 patients on the first few days of treatment. The effective dosage of Pergonal was found to be approximately 20 mg/day. Although Pergonal, when administered alone, induced some elevation of urinary estrogen, it did not elicit an increase in urinary pregnanediol excretion. When treatment with Pergonal alone was followed by the combined administration of Pergonal and HCG, an elevation of urinary estrogen and pregnanediol occurred. In most instances, endometrial biopsies showed a change from proliferative type (Pergonal alone) to progestational type (Pergonal plus HCG). Urinary 17-ketosteroids and 17-hydroxycorticosteroids were not affected. Bleeding occurred 14–21 days after initiation of the combined medication. Repeated administration of Pergonal elicited an ovarian resporse suggesting absence of sensitivity or refractiveness.