Summary. The existence of the enzyme prostaglandin E-2-9-ketoreductase which can convert prostaglandin E-2 to prostaglandin F-2\g=a\was

Summary Six infertile patients had been studied previously (Dodson et al., 1975b) and were shown to produce inefficient corpora lutea which appeared to be predetermined by ovulation of “poorly grown” follicles. In a second cycle these infertile patients were treated with 50 mg of clomiphene per day for five days. The resulting plasma sex steroid and gonadotrophin profiles were compared with those found before treatment and with the profiles in normal patients (Dodson et al., 1975a). Treatment with clomiphene appeared to produce increased follicular growth and more active corpora lutea. Thanks are due to Dr. Philip England, Research Department, Glasgow Royal Maternity Hospital, who supervised the LH assays; Mr. Alan Craig, Searle Scientific Services, who supervised the FSH assays; Dr. P. D. G. Dean for a gift of oestradiol antiserum; Mr. W. McNally, Department of Obstetrics and Gynaecology, for art work and the Medical Research Council for financial support (MRC 971/222/C).

Summary Sensitive and specific displacement analysis methods for the assay of steroid hormones in small volumes of plasma are described. Plasma sex steroid and gonadotrophin hormone patterns were determined throughout a number of normal menstrual cycles. The mean cycles showed patterns which were similar to those described by other workers. However, examination of individual cycles provided information which may contribute to our understanding of menstrual cycle regulation with particular reference to the pattern of 17a‐hydroxyprogesterone and steroid‐gonadotrophin interactions.

Summary 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.

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