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Relationship between endogenous urinary estrogen levels and progestogen withdrawal bleeding

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      Abstract

      Endogenous estrogen levels and progesterone withdrawal bleeding are useful in predicting the response to clomiphene citrate in ovulation induction in patients with secondary amenorrhea. In an attempt to correlate the two, 20 women with secondary amenorrhea had 24 hour urinary estrogen assays performed before administration of 17α-hydroxyprogesterone caproate. In 8 women, with estrogen levels above 11 μg bleeding occurred but did not in 5 with levels below 8 μg; between 8 and 11 μg the response was unpredictable. There was no correlation between estrogen levels and duration of amenorrhea or to the interval between progestogen administration and bleeding.
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