[Markers of the periovulatory phase with an eye toward insemination: E2/LH correlations].

We are investigating the most practical parameters i.e. reliable and with a rapid response, which allow the time of insemination to be determined in women undergoing stimulation because of anovulation. We have already shown the advantage of rapid radio-immunological determinations of 17 beta-oestradiol (E2) to induce the releasing action of chorionic gonadotrophic hormone (hCG). We have carried out our investigations directed towards the rapid-immunological determination of luteotrophic hormone (LH), and have recorded a good temporal correlation between E2 and LH, the rise of E2 preceding by some hours that of LH, and the two summits succeeding each other. Inseminations are followed by fertilization in women who present with the following: a mean oestradiolaemia of about 500 pg/ml in the second part of the follicular phase, maintained after interruption of HMG administration (alone or after clomiphene citrate), which decreases only slowly after administration of hCG; a level of LH increasing from 9-14 ng/ml (mean) in the last two days preceding the summit of LH; the level of LH multiplied at least by 2 after the administration of hCG, whatever the mode of stimulation. Clomiphene citrate, not provoking a constant ovulatory discharge, does not dispense with the administration of hCG in the majority of cases. These considerations result from the study of a group of 22 anovulatory women, in whom stimulation followed by determination of E2 and LH, under echographic control, have allowed 12 pregnancies to be obtained (7 by clomiphene citrate + HMG + hCG; 5 by HMG + hCG), decreasing the mean number of inseminated cycles to 3 per woman thus studied.