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Twelve patients with a normal menstrual rhythm were given 500 R.U. of antuitrin-S daily for four or six weeks. The majority of these patients did not show any significant alteration in rhythm. Five (42 per cent) experienced an amenorrhea of from one to five months following treatment. This induced amenorrhea was accompanied by a progressive atrophy of the endometrium, indicating a suppression of ovarian follicles. Antuitrin-S failed to establish uterine bleeding in patients with amenorrhea. No evidence of ovulation or luteinization, as demonstrated by a secretory endometrium, was found. On the basis of this experiment it appears that the anterior pituitary-like substances are not gonadotropic in the human female and in sufficient dosage may even be gonadotoxic.

SUMMARY Human proliferative endometrial tissue was maintained in organ culture. Glandular cells in the fragments were stimulated to secrete by adding progesterone to the culture medium—but not by insulin, oestradiol or cortisol; insulin enhanced the effect of progesterone. With progesterone, subnuclear vacuolation appeared in the glandular cells after 2–3 days. As the culture continued, these vacuoles disappeared and secretion into the lumen occurred.

1. 1. It has been too widely accepted that functional uterine bleeding is almost invariably associated with endometrial hyperplasia, but in our experience with 83 consecutive cases about 14 per cent are associated with secretory endometrium. 2. 2. Forty-one cases of functional uterine bleeding associated with secretory endometrium are studied in detail. (a) In most cases the complaint was simple menorrhagia. (b) Secretory endometrium was found during bleeding which lasted for as long as thirty-four days, and it was also found after prolonged bleeding associated with corpus luteum cysts, suggesting the possibility that with functional uterine bleeding secretory endometrium may persist for a long period of time.

SummaryThe results presented indicate the necessity for determination of the purity of the P.G. isolated from non-pregnant urine. It has been clearly shown that the modifications reported by Venning1 do not necessarily remove all impurities from the final product. The implications of these findings, for much of the data in the literature, are clear. In the light of our results, the finding (first reported by Hamblen, et al.,2 that P.G. may be present in the absence of a secretory endometrium, particularly warrants critical reexamination.

Summary1) 6α-methyl-17α-acetoxyprogesterone is a highly active progestin based on its ability to promote a secretory endometrium and to prevent ovulation in rabbits. 2) Subcutaneously, 6α-methyl-17α-acetoxyprogesterone is 6 to 8 times and orally 60 to 75 times as active as 17α-acetoxyprogesterone in the McPhail assay. The ability of the 6-methyl compound to inhibit ovulation in rabbits is at least 20 times as great as that of progesterone subcutaneously, while 17α-acetoxyprogesterone is 7 times as active as progesterone.

Electrophoretic separation of the fractions of lactic dehydrogenase in normal endometrium has been described. Fractions I, II, and III predominate in the proliferative phase of the cycle, while fractions III, IV, and V are most marked in the secretory phase. Endometrium of pregnancy and that from patients using oral progestins is similar to secretory endometrium in this respect. The suggestion that fractions IV and V are those most involved in anaerobic glycolysis has likewise been discussed.

A ligand-specific progesterone-binding protein which migrated in sucrose gradients, as a 4–5S complex, has been identified in endometrial cytosol. The association constant (Ka) for progesterone binding to cytosol protein was estimated at 1.2–3.4 i 109 M

Summary: A series of 50 patients whose pregnancy was complicated by incomplete abortion is reported. The average time which elapsed before the return of ovulation, as diagnosed by the demonstration of secretory endometrium histologically, was 50 days (range 10 to 104 days), and there was no difference between patients who aborted in the first and second trimesters. Twenty per cent of first menstruations were anovular and 6% of patients had 2 anovular menstruations prior to the return of ovulation.

Studies on the normal human endometrium using Bertalanffy's fluorescent microscopic technique were made. Our results revealed that DNA and RNA exist in rather constant amount in nonovulatory, proliferative, and secretory endometrium.

Sclerocystic ovarian disease is primarily a clinical diagnosis, since there is no pathognomonic physical finding or laboratory study. The purpose of this study was to evaluate in a planned manner consecutive patients suspected of having sclerocystic ovarian disease. Fifty-five consecutive clinic and private cases diagnosed by this plan were carefully studied in relation to menstrual history, physical findings, laboratory studies, and clinical follow-up. Criteria for operation were outlined. In this group of patients, 54 patients had secretory endometrium on first postoperative period, 44 continued regular ovulatory period for one year, and 63 per cent of patients with patent tubes became pregnant in the first 2 years postoperatively.

1. 1. An additional case of bilateral ovarian dermoids in pregnancy is reported, bringing the total number of reported cases up to 66. 2. 2. Of the total number of cases reported only 10 cases were treated with conservative ovarian surgery. 3. 3. The present patient treated conservatively has continued to menstruate normally and endometrial biopsy done 6 months post operation revealed secretory endometrium and thereby gives presumptive evidence of ovulation. 4. 4. A plea is made for conservative ovarian surgery and reasons are advanced to support this plea.

The earliest time at which ovulation may occur postpartum was investigated in this study of histological specimens of the endometrium. 128 endometrial biopsies were obtained, but only 92 had adequate material for study. Of the remaining 92 cases, decidual tissue was found in 11 cases, proliferative endometrium was found in 65 cases, and secretory endometrium was found in 16 cases. 12 of these 16 showed unequivocal secretory endometrium on or before the 43rd day postpartum; one was found as early as Day 33. The other 4 cases were found to be secretory between Days 44 and 93. 2 patients had menstruated once before biopsy. Those 16 cases with secretory endometrium ranged in age from 19-30 years; 12 of these women had had their pregnancy terminated between Weeks 38 and 41 and 3 women were terminated at Week 36, while 1 was terminated at Week of gestation. All women studied were nonlactating. Based on these data, contraceptive counseling postpartum should commence between Weeks 3 and 4 postpartum.

A method is presented for the study of the pH of the human uterine fluids and/or mucosa in situ. The hydrogen-ion concentration of the uterine cavity varies during the normal menstrual cycle. A decrease in the alkalinity of the uterine fluids and/or mucosa is associated with a corresponding secretory endometrium. The occurrence of ovulation appears to be accompanied by a period of relative acidity of the uterine fluids and/or mucosa.