Induction of Ovulation in the Human by Human Pituitary Gonadotropin 1 95 



Following each treatment a polycystic enlargement of the ovaries and an 

 increase in the estrogen excretion were found. No untoward effects, such as 

 fever or local reactions at the site of injections, were observed. 



Criteria of ovulation. The following criteria of ovulation were employed: 

 uterine biopsy, chemical determinations of estrone, estradiol- 17^, estriol 

 and pregnanediol. 



Table 1 . Evaluation of Endometrial Activity 



* Number of glandular cross-sections studied, necessary to detect one mitosis (Tillinger 

 and Westman, 1957). 



t Basal vacuolization similar to the one found in normal cycles (Noyes et ai, 1950). 



The endometrial activity was estimated according to Table 1 . 



The endometrium was atrophic (A) when no mitosis was found in sections 

 of the glandular epithelium, weakly proliferative (P) when more than 8 cross- 

 sections were required to detect one mitosis, moderately proliferative (P) 

 when less than 8 but more than 2 cross-sections were necessary and intensely 

 proliferative (P) when less than 2 were required to find one mitosis. 

 Endometrial secretory activity was differentiated into early secretion (ES) 

 with basal vacuolization, similar to that found in the 15th-18th day of the 

 normal cycle and full secretion (S) representing the 19th-28th day of the cycle. 



Urinary Steroid Assays. Estrogen assays were restricted to the estimation 

 of the 3 "classic" estrogens — estrone, estradiol- 17/3 and estriol. The method 

 of Brown (5) was used, with a slight modification as described by Diczfalusy 

 and Westman (6) and Brown et al. (7). The term "estrogen" will be used to 

 denote estrone, estradiol- 17/3 and estriol. 



Pregnanediol was estimated according to the method of Klopper et al. (8), 

 but the color correction equation of Allen (9) was used. The evidence in 

 favor of this modification has been presented by Diczfalusy (10). 



RESULTS 

 In evaluating the effect of human pituitary FSH it must be kept in mind that 

 the preparation contains small amounts of LH and that the patients have 

 their own pituitaries which may release FSH and/or LH. It would have been 

 advantageous if hypophysectomized patients could be tested. We have only 

 two who to a certain degree meet this requirement — a hypopituitary dwarf 



