Induction of Ovulation With Gonadotrophins

Ac, Crooke

doi:10.1093/oxfordjournals.bmb.a070736

Cited by 32 publications

(3 citation statements)

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“…A major problem with gonadotropin induction of ovulation has been the high incidence of multiple follicle development with the attendant increased risk of multiple pregnancy and of ovarian hyperstimulation syndrome (OHSS) (Gemzell 1966, Crooke 1970, Schwartz et al 1980, Balen et al 1994, Franks & Gilling-Smith 1994, Tadokoro et al 1997. These risks can be limited by the use of a low-dose 'step-up' regimen, which was introduced in the 1980s and which, for the last 15-20 years has largely taken the place of conventional (i.e.…”

Section: Introductionmentioning

confidence: 99%

Low-dose gonadotropin induction of ovulation in anovulatory women: still needed in the age of IVF

White¹,

Hardy²,

Lovelock³

2018

Reproduction

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26Low-dose, step-up gonadotropin is the treatment of choice for women with polycystic ovary 27 syndrome (PCOS) who have not conceived after anti-estrogen treatment, and as an effective 28 alternative to pulsatile GnRH in women with hypogonadotropic hypogonadism (HH). There 29 has been, however, no large-scale, comparative study between the two groups using low-30 dose gonadotropins. Here we performed a retrospective, comparative analysis, in a single 31 clinic database, of efficacy and safety of induction of ovulation using low-dose 32 gonadotropins in 364 Women with PCOS and 80 women with HH. 33The rate of ovulation was high in both PCOS (83%) and HH (84%) but mono-follicular, 34 ovulatory cycles were more prevalent in PCOS than in HH (77% vs 53%, p<0.0001) and the 35 proportion of cycles that were abandoned was higher in HH than in PCOS (25% vs 15%, 36 p<0.0001). The median threshold dose of gonadotropin required to induce ovulation was 37 75iu/day in PCOS and 113iu/day in HH (p<0.001) and the range of doses was greater in HH 38women. Forty-nine percent of women with PCOS and 65% of those with HH conceived 39 (more than 90% within 6 cycles of treatment) and had a least one pregnancy. Multiple 40 pregnancies (all twins) occurred in only 4% of women with PCOS and 5% of those with HH. 41These findings emphasise the efficacy and safety of low-dose gonadotropin treatment for 42 both clomiphene-resistant women with PCOS and those with HH. These results highlight the 43 importance of choosing the more physiological approach of gonadotropin induction of 44 ovulation in both groups as the most appropriate treatment, in preference to IVF. 45 46

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Section: Introductionmentioning

confidence: 99%

Low-dose gonadotropin induction of ovulation in anovulatory women: still needed in the age of IVF

White¹,

Hardy²,

Lovelock³

2018

Reproduction

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“…Brief clinical details and the methods of treatment with human gonadotrophins of patients with failure of ovulation whose pregnancies are described herein have been re corded in a previous paper [4], The case numbers are the same in both papers. The num bers 1, 2 and 3 in brackets which sometimes follow the case numbers indicated the 1st, 2nd or 3rd pregnancy in those who had more than 1 pregnancy following treatment with gonadotrophins.…”

Section: Methodsmentioning

confidence: 99%

Hormone Excretion in Pregnancy Following Gonadotrophin Treatment

Crooke¹,

Butt²,

Bertrand³

et al. 1971

Horm Res Paediatr

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40 consecutive pregnancies following treatment of infertile women with gonadotrophins were investigated. The 24-hourly excretion of oestriol, pregnanediol and chorionic gonadotrophin was measured at weekly intervals and correlated with the clinical findings. 23 pregnancies resuited in single babies, 6 in twins, 1 in triplets and 10 in abortion. Twelve single pregnancies were clinically normal and were used as a control group to estimate the mean and 95% confidence limits of the 24-hour excretions, and the mean and 95% confidence limits of the weekly rates of increase of each hormone excreted. These figures were used to determine if threatened abortion, abortion, pre-eclamptic toxaemia or multiple pregnancy could be predicted from the excretion of the hormones. Abnormally low excretion of at least 1 of the steroids occurred before clinical evidence of threatened abortion in 4 of 10 cases, abortion in 6 of 10 cases and pre-eclamptic toxaemia in 3 of 8 cases. The excretion of all steroids appeared to be raised in multiple pregnancies but the difference between the mean of these and the mean for single pregnancies was not significant, probably because of the wide scatter. The usefulness of hormone assays in pregnancy is discussed.

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“…The main clinical problems associated with the use of gonadotrophin in the treatment of infertility are those of overstimulation of the ovary (Mazes et alii, 1965), and of multiple pregnancy. A variety of dose schedules designed to minimize these risks has been described, but none are completely satisfactory (Crooke, 1967). It has been our practice to administer H.P.G.…”

Section: Therapeuticmentioning

confidence: 99%

The Clinical Uses of Human Gonadotrophins

Taft

Adey

Brown

et al. 1968

Australasian Annals of Medicine

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Summary With the recent preparation of hormones from human pituitaries and human postmenopausal urine, a wider range of pituitary gonadotrophin activity has become available for clinical use. To the luteinizing and interstitial cell stimulating effects of gonadotrophin prepared from human placentas can now be added the follicle stimulating activity of pituitary and urinary gonadotrophin. The clinical applications of these hormones lie in both the diagnostic and therapeutic fields. Their administration as gonadal stimulants followed by measurement of gonadal response allows an assessment of function and the determination of the level of gonadal failure. The range of biological gonadotrophic activity of these hormones allows their use as effective replacement therapy in gonadotrophin deficiency states in both sexes and for the infertile female, even in the absence of obvious hypogonadotrophinism.

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Induction of Ovulation With Gonadotrophins

Cited by 32 publications

References 0 publications

Low-dose gonadotropin induction of ovulation in anovulatory women: still needed in the age of IVF

Low-dose gonadotropin induction of ovulation in anovulatory women: still needed in the age of IVF

Hormone Excretion in Pregnancy Following Gonadotrophin Treatment

The Clinical Uses of Human Gonadotrophins

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