Ovulation induction with gonadotropins in women with polycystic ovary disease.
Seventy-two infertile women with polycystic ovary disease (PCOD) and clomiphene citrate treatment failure underwent 220 human menopausal gonadotropin (hMG) and human chorionic gonadotropin (hCG) treatment cycles for ovulation induction over a period of 19 months. Forty-two patients ovulated but failed to conceive on clomiphene, and the remaining 30 failed to ovulate on clomiphene. Monitoring of treatment consisted of serum 17 beta-estradiol (E2) levels and ultrasonic assessment of follicular growth. Treatment was withheld whenever the E2 levels exceeded 1,500 pg/mL and/or when more than two follicles greater than or equal to 17 mm in diameter each were encountered on ultrasonography. Twenty-nine patients conceived (40.2%), and 23 delivered viable infants. Twenty-three of the 29 pregnancies were achieved in the 42 patients who ovulated on clomiphene, while only 6 pregnancies resulted in the 32 anovulatory patients on clomiphene. Six patients (20.6%) aborted in the first trimester. Multiple pregnancies consisted of only two sets of twins (6.9%). There were only two cases of mild hyperstimulation (2.7%) and no severe hyperstimulation. Because of the low occurrence of multiple pregnancies and hyperstimulation and the reasonable success rate, all PCOD patients should be started on this protocol.
Kupferminc
M J
MJ
Department of Obstetrics and Gynecology, A Serlin Maternity Hospital, Tel-Aviv, Israel.
Lessing
J B
JB
Peyser
M R
MR
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D002996:Clomiphene / Q000008:administration & dosage / Q000627:therapeutic use; D004958:Estradiol / Q000097:blood; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D010062:Ovulation Induction / Q000379:methods* / Q000592:standards; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D011256:Pregnancy Outcome
D006063:Chorionic Gonadotropin; D002996:Clomiphene; D004958:Estradiol; D008596:Menotropins