[Ovulation induction by pulsatile intravenous administration of Gn-RH to patients with hypothalamic amenorrhea].
Intravenous pump administration (Zyklomat, Ferring) of GnRH (Lutrelef, Ferring) has been used to induce ovulation in 16 patients suffering from hypothalamic amenorrhea between January 1989 and December 1991. One to 6 cycles were performed for a total of 47 cycles. GnRH pulses were set at 20 micrograms/pulse every 90 min up during the follicular phase and decreased to 1 pulse/120 min during the 3-5 days following ovulation. Thereafter, the luteal phase was supported by 1000 IU HCG/48 h up to the end of the 5th week. Response to the treatment was monitored with seriC E2, P and LH and vaginal echography. Cycles (N = 3) were cancelled when E2 did not reach at least 0.25 nmol/l after 30 days. An E2 level > 0.8 nmol/l, associated with a mature follicle (> 20 mm), and the presence of a LH peak or an increased progesterone level were used to determine the day of ovulation. In case of normozoospermy (N = 9), sexual intercourse was recommended to the patients (27 cycles), whereas an intrauterine insemination was performed in case of a male factor (N = 7, 20 cycles). Results can be summarized as follows: 39 (83%) cycles were ovulatory and led to 9 (19%) clinical and 6 (13%) biochemical pregnancies. Five (8.5%) pregnancies aborted and 5 (11%) came to full term. After exclusion of the male factors, the pregnancy rate reaches 26%/initiated cycle, 28%/ovulatory cycle and 56%/patient. No patient developed a hyperstimulation syndrome or a multiple pregnancy. Three cycles (6.3%) were interrupted due to 2 superficial phlebitis and 1 pump failure.(ABSTRACT TRUNCATED AT 250 WORDS)
Dessole
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Dipartimento di Ginecologia ed Ostetricia, Centro Ospedaliero Universitario Vaudois, Losanna, Svizzera.
Germond
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Senn
A
A
Welti
H
H
De Grandi
P
P
D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology; D007247:Infertility, Female / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D007262:Infusions, Intravenous; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy
D007987:Gonadotropin-Releasing Hormone
Induzione dell'ovulazione con somministrazione pulsatile intravenosa di Gn-RH in pazienti con amenorrea ipotalamica.