title: Ovulation induction with subcutaneous pulsatile gonadotropin-releasing hormone: singleton pregnancies in patients with previous multiple pregnancies after gonadotropin therapy.
abstract: Three patients with hypothalamic amenorrhea who had previously had multiple pregnancies following gonadotropin therapy were treated with subcutaneous pulsatile gonadotropin-releasing hormone (GnRH), administered by a portable pump. After treatment with lower doses in some cases, pulses of 5 to 10 micrograms were given at 90-minute intervals, resulting in ovulation on six occasions. Ovarian steroid profiles closely resembled those of normal ovulatory cycles, and spontaneous ovulation of a single ovarian follicle was consistently demonstrated by ultrasound. Singleton pregnancy was confirmed in each patient. The results imply normal operation of the ovarian-pituitary feedback loop and suggest that subcutaneous pulsatile GnRH therapy is a safe and effective means of ovulation induction in clomiphene-resistant cases of hypothalamic amenorrhea and may possibly become the preferred method of treatment.
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy*; D004970:Estrone / Q000652:urine; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D010060:Ovulation / Q000187:drug effects*; D010906:Pituitary Hormone-Releasing Hormones / Q000008:administration & dosage*; D011247:Pregnancy; D011272:Pregnancy, Multiple / Q000187:drug effects*; D011276:Pregnanediol / Q000652:urine
chemical_list: D010906:Pituitary Hormone-Releasing Hormones; D004970:Estrone; D011276:Pregnanediol