The induction of ovulation by pulsatile administration of GnRH: an appropriate method in hypothalamic amenorrhea.

Details

Serval ID
serval:BIB_4D15FE4EC17A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The induction of ovulation by pulsatile administration of GnRH: an appropriate method in hypothalamic amenorrhea.
Journal
Gynecological endocrinology
Author(s)
Christou F., Pitteloud N., Gomez F.
ISSN
1473-0766 (Electronic)
ISSN-L
0951-3590
Publication state
Published
Issued date
08/2017
Peer-reviewed
Oui
Volume
33
Number
8
Pages
598-601
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The induction of ovulation by the means of a pump which assures the pulsatile administration of GnRH is a well-known method that applies to women suffering from amenorrhea of hypothalamic origin. Although a simple and efficient method to establish fertility, it is underused. Twelve patients suffering from this condition, 1 Kallmann syndrome, 4 normosmic isolated hypogonadotropic hypogonadism, and 7 functional hypothalamic amenorrhea desiring pregnancy were treated. They underwent one or more cycles of pulsatile GnRH, at a frequency of 90 minutes, either by the intravenous or the subcutaneous route. An initial dose of 5 μg per pulse in the intravenous route was administered and of 15 μg per pulse in the subcutaneous route. The treatment was monitored by regular dosing of gonadotropins, estradiol and progesterone, and the development of follicles and ovulation was monitored by intra-vaginal ultrasonography. All the patients had documented ovulation, after a mean of 17 days on pump stimulation. Single ovulation occurred in 30 of 33 treatment cycles, irrespective of the route of administration. Ovulation resulted in 10 pregnancies over 7 patients (2 pregnancies in 3 of them), distributed in the 3 diagnostic categories. For comparison, a patient with PCOS treated similarly, disclosed premature LH surge without ovulation.
Keywords
Adult, Amenorrhea/etiology, Amenorrhea/physiopathology, Cohort Studies, Drug Administration Schedule, Female, Fertility Agents, Female/administration & dosage, Fertility Agents, Female/therapeutic use, Gonadotropin-Releasing Hormone/administration & dosage, Gonadotropin-Releasing Hormone/therapeutic use, Humans, Hypogonadism/physiopathology, Hypothalamic Diseases/physiopathology, Infertility, Female/etiology, Infertility, Female/therapy, Infusion Pumps, Infusions, Intravenous, Infusions, Subcutaneous, Kallmann Syndrome/physiopathology, Lost to Follow-Up, Ovulation Induction, Pregnancy, Pregnancy Rate, Recombinant Proteins/administration & dosage, Recombinant Proteins/therapeutic use, Retrospective Studies, Switzerland/epidemiology, GnRH pump, hypothalamic amenorrhea, ovulation induction
Pubmed
Web of science
Create date
21/03/2017 19:56
Last modification date
20/08/2019 15:01
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