Serial monitoring of serum estradiol and progesterone levels during the HMG-HCG therapy in sex anovulatory women.

Serum estradiol (E2) and progesterone (P) levels were radioimmunoassayed every or every other day for monitoring the HMG-HCG therapy in six anovulatory patients, and the clinical significance of measuring steroid hormones as precautionary counterplot against the ovarian hyperstimulation syndrome and multiple pregnancies was evaluated. Administration of HCG is recommended to trigger ovulation when serum E2 levels reach 400-600 pg/ml. Mean peak P level in 7-8 days after ovulation induced by HMG-HCG was 22.9 ng/ml, which is significantly higher than P levels of the same period in spontaneous and clomiphene-induced ovulations. This result suggests that there may occur multiple ovulations which result in multiple pregnancies in HMG-HCG therapy.