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To elucidate the role of the vasodilatory prostacyclin (PGI2) in human ovulation, urinary samples were collected from spontaneously ovulating women (n= 8) and from those undergoing ovulation induction with clomiphene (seven women, 9 cycles) and human gonadotropins (five women, 11 cycles). The samples were assayed for 6-keto-prostaglandin F1α(6-keto-PGF1α), a breakdown product of PGI2, employing high-pressure liquid chromatography and radioimmunoassay. The urinary 6-keto-PGF1αwas not consistently related to the menstrual cycle day at collection, the occurrence of spontaneous (n= 8) or induced (n= 11) ovulation, or the simultaneous concentration of estradiol in plasma. However, its concentrations both before and after the approximated time of ovulation during clomiphene (41.6 ± 6.7 and 52.7 ± 7.9 pmol/mmol creatinine, before/after, mean ± standard error) or gonadotropin treatment (49.0 ± 5.8 and 48.1 ± 6.8 pmol/mmol creatinine) were higher (P< 0.01) than those in spontaneously ovulating women (26.4 ± 3.8 and 20.5 ± 3.0 pmol/mmol creatinine, respectively). Multiple ovarian follicles, as assessed ultrasonographically, developed during four courses of the treatments with gonadotropins, and in three of them the urinary 6-keto-PGF1αwas high. The data suggest that treatment with clomiphene and gonadotropin is accompanied by increased production of PGI2, perhaps in the ovaries and/or in the kidneys. This may perhaps play a role in the etiopathogenesis of ovarian hyperstimulation syndrome.

To study the presence of prostaglandin F2α(PGF2α), prostacyclin (PGI2), and thromboxane A2(TxA2) in the human ovary, follicular fluid samples were collected with puncture at laparoscopy in 17 women with pelvic endometriosis, 17 women with tubal occlusion and healthy ovaries, and 5 women with tubal occlusion and induced ovarian hyperstimulation between menstrual cycle days 8 and 18. The concentrations of the metabolites of PGF2α, PGI2, and TxA2, i.e., 13,14-dihydro-15-keto PGF2α(M-PGF2α), 6-keto PGF1α, and TxB2, respectively, were measured with radioimmunoassays. Each prostanoid was detected in follicular fluid, but their concentrations were unrelated to the menstrual cycle day at collection. Moreover, these concentrations were similar in various groups of patients. The data suggest that the human ovary produces PGF2α, PGI2, and TxA2in vivo and that these prostanoids, as measured from follicular fluid, may not be of primary significance in ovulation or endometriosis.