Vaginal cytology and the human menopausal gonadotropin-test (HMG-cytohoromonal-test) in cases of gonadal dysgenesis.

Cytohormonal investigations and HMG-cytohormonal-test were carried out in 15 patients suffering from gonadal dysgenesis and the results were compared with the histology of the gonad, the karyotype and the clinical appearance. All patients were primary amenorrhoeic. According to the gonad histology and the phenotype the term "gonadal dysgenesis" was subdivided into Turner's syndrome, pure gonadal-dysgenesis and syndrome of ovarian hypoplasia. For the HMG-cytohormonal-test Humegon was administrated three times in weekly intervals (one amp. 75. i.u. in the first, two amp. in the second and three amp. in the third week). The gonadal response to Humegon was detected by vaginal cytology taken on the first, second, fourth and sixth days, after each injection of Humegon. Smears in patients with streak gonads irrespective of their phenotype were completely atrophic and did not change following Humegon administration. This finding seems to be characteristic and the HMG-cytohormonal-test is a simple way to diagnose the presence of the streak gonad. Cytohormonal patterns in the syndrome of ovarian hypoplasia accompanied by primary amenorrhoea consisted of mostly intermediate cells although superficial cells in five to 20 per cent and parabasal cells in five per cent also occurred. Following Humegon administration there were no or slight changes in the smears, much less marked than those in secondary ovarian failure.