Inhibition of Ovulation in the Human 



231 



ectopic endometrium not uncommonly regresses. Dr. Robert W. Kistner (37) 

 has already published extensively on his successful use of Enovid in endo- 

 metriosis. At the Reproductive Study Center, Dr. Garcia gave continuous 

 Enovid medication to patients in their twenties and thirties for time intervals 

 ranging from 2 to 9 months. This continuous administration afforded an 

 opportunity to evaluate the effects on ovulation after discontinuance of such 

 long-term therapy. 



Table 13. Effect on Recurrence of Ovulation Following Cessation of Long-term 

 Enovid* Therapy for Endometriosis 



* TTie regimen was as follows: lOmg/day for 2 weeks; 20 mg/day for the 3rd and 4th 

 weeks ; then 30 mg/day for 2 to 3 months. 



As seen in Table 13, even after treatment with 10-20 mg per day for one 

 month and then 30 mg a day for 2-3 months, no permanent damage was 

 done to ovulation potential. In the first postmedication cycle, ovulation 

 occurred in 70% of 13 patients; and in the second postmedication cycle, all 

 of 7 patients tested were found to have ovulated. Fairly prompt recurrence of 

 ovulation is a constant finding after intermittent consumption of this material, 

 as has been pointed out previously (22). 



B. Effect of Enovid or Norlutin on the Ovaries 



The question arose: How about the effect of long-term use of these 

 substances on primordial follicles? Do these steroids, norethynodrel and 

 3-methyl-ether of ethynylestradiol (Enovid) or norethindrone (Norlutin), 

 cause atresia, not only of the ripe follicles or the second-grade ones, but do 

 they also cause destruction of the reserve ova ? 



This was difficult to determine. Dr. Richard R. Thornton, then a medical 

 student, was kindly permitted to search through the pathological material 

 at the Massachusetts General Hospital and to collect all the normal ovaries 

 he could. These contributed largely to the untreated control material. For 

 comparison, some ovaries were obtained from our own patients treated with 

 Enovid before required oophorectomy. They were supplemented by ovarian 

 biopsies from the Puerto Rican study, most of which were supplied by 

 Dr. Pendleton. 



As shown in Fig. 4, the treated and the control cases were divided into 

 age groups: 18-21 ; 22-25; 26-29 years of age, etc. Serial sections were made 



