A total of 182 women with uterine anomalies were observed over a period of 18 years. In all, 126 women had 265 pregnancies, fetal survival rate was 66%, perinatal mortality 8% and premature labors occurred in 23%. When the uterine anomalies were grouped according to degree of failure of normal and uterine development, the complete septate uteri had the best fetal survival rate (86%), complete bicornuate uteri (50%) and unicornuate (40%) poorest. Cervical cerclage was applied most in the partial bicornuate uteri (17%), where fetal survival in operated cases was: before operation, 53% and after, 100%. The frequency of breech presentation was 40-50% in all groups except complete septate uteri (25%) and complete bicornuate (0%). The highest cesarean section rate (82%) was in deliveries of patients with uterus didelphys. The frequency of cesarean section among total deliveries was 53%. Metroplasty was carried out on 19 patients. The obstetric outcome improved from 10% successful pregnancies before surgery to 88% postoperatively.
Specific high affinity, low capacity binding of [ l25 I]iodo-hCG was demonstrated in homogenates of isolated granulosa cells and corpora lutea of human ovary throughout the menstrual cycle and pregnancy. The binding of radiolabeled hCG to the receptor was time, temperature, ion concentration, and pH dependent. The treatment of ovarian membrane particles with trypsin decreased binding by about 75%, whereas treatment and neuraminidase resulted in a 400% increase in binding. These results suggest a protein nature of the receptor and that a portion of the receptors may be masked in the membrane by sialic acid. The receptor displayed high specificity for hCG and human LH, indicating that they share the same receptor site in the human ovary. The receptor bound hCG with high affinity. The apparent equilibrium association constant for hCG was 2.2 X 10 9 M~\ The receptor concentration increased from the early follicular phase to ovulation by about 1.6-fold. After an apparent transient fall associated with the ovulatory period, the receptor concentration increased further by about 4-fold by day 17 of the cycle and thereafter remained virutally unchanged until the end of the cycle. Homogenates of corpora lutea obtained during the follicuar phase aso bound specifically radiolabeled hCG, suggesting that the regression of the corpora lutea is not primarily due to the loss of receptors for human LH. The receptor concentration measured in corpora lutea of early pregnancy was clearly lower than that in corpora lutea of the menstrual cycle. This is most likely due to occupation and downregulation of the receptors by high serum hCG. The number of receptors in corpora lutea tended to increase towards the end of pregnancy.Our results indicate that the maturation and subsequent luteinization of human ovarian follicles is associated with a biphasis increase in the number of LH (hCG) receptors in granulosa cells. The changes in the concentration of available receptor may have a determining role in the regulation of follicular and corpus luteum development and function. (J Clin Endocrinol Metab 108: 307, 1981) H UMAN LH (hLH) and hCG appear to be the major luteotropic factors for the human corpus luteum during the menstrual cycle and pregnancy (1-4). Specific stimulation of steroidogenesis in human corpora lutea by hLH and hCG has been demonstrated in vitro (1, 2, 5). In addition, the administration of hCG in vivo during the early luteal phase prolongs the lifespan and function of the corpus luteum to a certain extent, but not beyond 9 days (3, 4). Other data have shown that hLH can also extend the lifespan of the corpus luteum of the menstrual cycle and increase the serum progesterone concentration (3, 4). Fundamental to our understanding of regulation of follicular development and corpus luteum function is knowledge of the properties of the gonadotropin recep-
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