title: Prospective, randomized comparison between pulsatile GnRH therapy and combined gonadotropin (FSH+LH) treatment for ovulation induction in women with hypothalamic amenorrhea and underlying polycystic ovary syndrome.
abstract: OBJECTIVE
  To compare the efficacy of pulsatile GnRH therapy versus combined gonadotropins for ovulation induction in women with both hypothalamic amenorrhoea and polycystic ovarian syndrome (HA/PCOS) according to their current hypothalamic status.
  
  
  METHODS
  This single-centre, prospective, randomized study was conducted in the Nantes University Hospital, France. Thirty consecutive patients were treated for ovulation induction with either pulsatile GnRH therapy or combined gonadotropins (rFSH+rLH). Frequency of adequate ovarian response (mono- or bi-follicular) and clinical pregnancy rate were then compared between both groups.
  
  
  RESULTS
  Ovarian response was similar in both groups with comparable frequency of adequate ovarian response (73% vs 60%), but the clinical pregnancy rate was significantly higher in the pulsatile GnRH therapy group than in the combined gonadotropin group (46% vs 0%).
  
  
  CONCLUSIONS
  HA/PCOS is a specific subgroup of infertile women. Pulsatile GnRH therapy is an effective and safe method of ovulation induction that can be used successfully in these patients.
authors.affiliation: Médecine et Biologie de la Reproduction, Hôpital Mère et Enfant, CHU de Nantes, 38 boulevard Jean Monnet, 44093 Nantes cedex, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Dubourdieu
authors.forename: Thomas
authors.initials: T
authors.lastname: Fréour
authors.forename: Lionel
authors.initials: L
authors.lastname: Dessolle
authors.forename: Paul
authors.initials: P
authors.lastname: Barrière
mesh_terms: D000328:Adult; D000568:Amenorrhea / Q000188:drug therapy* / Q000209:etiology; D004338:Drug Combinations; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000188:drug therapy; D007986:Luteinizing Hormone / Q000008:administration & dosage*; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D018873:Pregnancy Rate
chemical_list: D004338:Drug Combinations; D007987:Gonadotropin-Releasing Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone