Hormones for Fertility

Fertility clinics across the U.S. were swamped last week with anxious pleas for "that new drug that makes twins or quads." The furor was touched off by the disclosure that at Columbia-Presbyterian Medical Center a New York City woman who had been barren for six years had borne quadruplets after treatment with a new hormone preparation. The drug has not only promoted fertility in many of the cases in which it has been tried, but has also increased the likelihood of multiple births. Of 21 women treated at Columbia, 15 became pregnant, and the seven completed pregnancies have produced three single babies, three sets of twins, and Mrs. Martin Brecker's quads.

There are, in fact, two such drugs now under investigation by U.S. fertility researchers. Both are scarce and forbiddingly expensive. But both are of great interest to the small percentage of women who are infertile because they do not ovulate -- whose ovaries do not release an ovum, ready for fertilization, once every month, as do the ovaries of normal women.

For such cases of sterility, Swedish researchers headed by Uppsala's Dr. Carl Gemzell have devised injections of gonad-stimulating hormones extracted from pituitary glands obtained at autopsy. In many cases, ten to 15 days of injections over a month or two induced ovulation, and the women bore one or more normal babies. In Sweden there were two sets of quads. While the Swedish research was progressing, an Italian endocrinologist, Dr. Pietro Donini, began extracting gonad-stimulating hormones from the urine of women who had passed the menopause. It takes three gallons of urine to produce enough of the extract, called Pergonal, for one injection.

Both the Swedish and Italian preparations are indeed promising for eventual cure of infertility in a small proportion of women. The Swedish extract has even been shown to restore fertility in a man who had lost it because of an operation for pituitary cancer. But there is some danger that the injections may promote the growth of ovarian cysts, and have other harmful side effects. Nobody is preparing the pituitary extract for general use. Cutter Laboratories of Berkeley, Calif., has sole rights to make and market Pergonal in the U.S., but it will take the FDA months or years to decide whether the drug should be cleared for general use. Meanwhile, the fertility research centers are booked solid for all available supplies, and they cannot take care of any more patients.

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