Is multiple pregnancy an unavoidable complication of ovulation induction? The case for pulsatile GnRH.
Ovarian hyperstimulation (OHS) and multiple pregnancy are dreaded complications of ovulation induction. The use of pulsatile GnRH permits to prevent the occurrence of OHS and results in few multiple pregnancies. Low-dose GnRH administration, avoidance of preovulatory hCG, patient selection, and the use of GnRH agonist pituitary desensitization in selected patients permits to limit multiple conceptions to a level comparable with the occurrence of this complication in normal unstimulated women.
Filicori
M
M
Department of Obstetrics and Gynecology, University of Bologna, Italy.
Cognigni
G E
GE
Arnone
R
R
Carbone
F
F
Falbo
A
A
Tabarelli
C
C
Pari
C
C
Ciampaglia
W
W
Casadio
P
P
Spettoli
D
D
Pecorari
R
R
D006063:Chorionic Gonadotropin / Q000008:administration & dosage; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000517:prevention & control; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011272:Pregnancy, Multiple
D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone