Aim of the study: We studied ovulation and pregnancy rates following follicular maturation by administration of pulsatile gonadotrophin-releasing hormone (GnRH) in women with hypothalamic amenorrhea (HA). Material and methods: A total of 31 patients presenting documented HA were treated between January 1989 and December 1995. One to six cycles for a total of 103 cycles were stimulated by GnRH administrated at a dose of 20 µg/pulse every 90 minutes in follicular phase, and every 120 minutes 3-5 days after the ovulation. Luteal phase was supported by 1000 IU HCG/48h (Profasi, Serono). Each cycle was monitored using estradiol (E2), progesterone (P), luteinizing hormone (LH) assays and vaginal echography. Ovulation was confirmed when E2 level > 0,8 nmol/l was observed in the presence of an LH peak and when a follicle > 18 mm in diameter was observed by vaginal echography. When no male factor was observed (n=18) sexual intercourse was recommended. In case (n=13) of associated male infertility (number of normal or motile spermatozoa recovered < 5.106) one insemination was performed 24 to 36 hours after the ovulation criteria have been observed. Results: Ovulation and pregnancy rates were respectively 81% (n=84) and 21% (n=22). Six (6%) biochemical pregnancies were observed. Spontaneous abortion occurred in 7 (7%) cases. Fourteen full term deliveries were obtained (15%) and one pregnancy is ongoing. Conclusion: In our opinion, pulsatile GnRH is an efficient and safe treatment of anovulation in HA patients. Neither multiple pregnancy nor ovarian hyperstimulation syndrome (OHSS) have been observed. Pulsatile GnRH administration allows to obtain high rates of ovulation and conception.
Ovulation induction with pulsatile gonadotrophin-releasing hormone (GnRH) in women with hypothalamic amenorrhea
MARCI, Roberto;
1996
Abstract
Aim of the study: We studied ovulation and pregnancy rates following follicular maturation by administration of pulsatile gonadotrophin-releasing hormone (GnRH) in women with hypothalamic amenorrhea (HA). Material and methods: A total of 31 patients presenting documented HA were treated between January 1989 and December 1995. One to six cycles for a total of 103 cycles were stimulated by GnRH administrated at a dose of 20 µg/pulse every 90 minutes in follicular phase, and every 120 minutes 3-5 days after the ovulation. Luteal phase was supported by 1000 IU HCG/48h (Profasi, Serono). Each cycle was monitored using estradiol (E2), progesterone (P), luteinizing hormone (LH) assays and vaginal echography. Ovulation was confirmed when E2 level > 0,8 nmol/l was observed in the presence of an LH peak and when a follicle > 18 mm in diameter was observed by vaginal echography. When no male factor was observed (n=18) sexual intercourse was recommended. In case (n=13) of associated male infertility (number of normal or motile spermatozoa recovered < 5.106) one insemination was performed 24 to 36 hours after the ovulation criteria have been observed. Results: Ovulation and pregnancy rates were respectively 81% (n=84) and 21% (n=22). Six (6%) biochemical pregnancies were observed. Spontaneous abortion occurred in 7 (7%) cases. Fourteen full term deliveries were obtained (15%) and one pregnancy is ongoing. Conclusion: In our opinion, pulsatile GnRH is an efficient and safe treatment of anovulation in HA patients. Neither multiple pregnancy nor ovarian hyperstimulation syndrome (OHSS) have been observed. Pulsatile GnRH administration allows to obtain high rates of ovulation and conception.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
