title: Induction of single ovulation by sequential follicle-stimulating hormone and pulsatile gonadotropin-releasing hormone treatment.
abstract: OBJECTIVE
  To induce single follicular ovulation by sequential treatment with FSH and pulsatile GnRH.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  Eighteen hypogonadotropic anovulatory patients.
  
  
  METHODS
  In sequential treatment, daily FSH injection was switched to pulsatile GnRH administration (20 micrograms/120 minutes SC) when the follicle diameter reached 11 mm. In conventional FSH treatment, daily FSH injection was continued. In both cycles, hCG was given when the diameter of the dominant follicle reached 18 mm.
  
  
  METHODS
  Developed follicle numbers and serum FSH concentrations during treatment.
  
  
  RESULTS
  Single follicular development was achieved in 80.0% of cycles by sequential treatment but in no cycle by conventional FSH treatment. The number of developed follicles was 1.26 +/- 0.55 (mean +/- SD) on sequential treatment and 3.94 +/- 1.48 on conventional FSH treatment. Preovulatory FSH level was significantly lower on sequential treatment than on conventional FSH treatment (5.26 +/- 1.80 versus 11.55 +/- 3.43 mIU/mL [conversion factor to SI unit, 1.00]).
  
  
  CONCLUSIONS
  The sequential treatment achieved single follicular development without complications. The sequential FSH-pulsatile GnRH treatment may offer a better chance for development of a single dominant follicle and ovulation.
authors.affiliation: School of Medicine, Department of Obstetrics and Gynecology, University of Tokushima, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Kuwahara
authors.forename: T
authors.initials: T
authors.lastname: Matsuzaki
authors.forename: H
authors.initials: H
authors.lastname: Kaji
authors.forename: M
authors.initials: M
authors.lastname: Irahara
authors.forename: T
authors.initials: T
authors.lastname: Aono
mesh_terms: D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage* / Q000097:blood; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006801:Humans; D010062:Ovulation Induction / Q000379:methods*; D011446:Prospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone