Ten-year follow-up of patients with secondary amenorrhea and normal prolactin.

A group of 46 patients with secondary amenorrhea without galactorrhea or hyperprolactinemia were studied retrospectively after being clinically categorized into four groups with the use of progesterone-induced uterine bleeding and measurement of serum gonadotropins and prolactin levels. The ability to have regular spontaneous menstrual cycles and to conceive was assessed after a follow-up period of 10 years. Patients who had been classified as having hypothalamic pituitary "failure" (hypoestrogenic amenorrhea) with low levels of circulating estradiol had a greater rate of recovery of spontaneous ovulation and menses when compared with patients who had been classified as having only hypothalamic pituitary dysfunction (euestrogenic amenorrhea).

Early detection of pregnancy with transvaginal ultrasound.

The gestational age and the serum human chorionic gonadotropin (hCG) at which an intrauterine pregnancy can be detected using transvaginal ultrasonography (TVU) is not known. In this study, ten pregnant women were serially scanned with TVU from the time of initial positive pregnancy test, to determine when an intrauterine sac greater than 2 mm, fetal pole greater than 2 mm, and fetal heart motion could be detected. A gestational sac was seen 34.

Monitoring techniques to predict and detect ovulation.

This study was designed to evaluate the accuracy of various methods in predicting and detecting ovulation in 14 spontaneous and 17 clomiphene citrate (CC)-induced cycles. From cycle day 11 all subjects (n = 27) were followed with daily transvaginal ultrasound; rapid measurement of serum luteinizing hormone (LH) and estradiol (E2); determination of urinary LH with First Response (Tambrands Inc., Palmer, MA) and Ovustick (Monoclonal Antibodies, Inc.

Management of patients with hyperprolactinemia and normal or abnormal tomograms.

Forty women with hyperprolactinemia with and without radiologic evidence of prolactin-secreting pituitary adenoma were prospectively treated with bromocriptine. On the basis of tomographic studies, the patients were divided into either a microadenoma group (N = 19) or no adenoma group (N = 21). Both groups had similar distributions as to obstetric history, menstrual abnormalities, levels of baseline serum luteinizing hormone, follicle-stimulating hormone, and thyrotropin.