Treatment of Polycystic Ovarian Disease by Inducing Ovulation With Pulsatile Subcutaneous Administration of Human Menopausal Gonadotrophin Associated With Luteinizing Hormone‐releasing Hormone Analogue

Abstract

Treatment with a combination of luteinizing hormone-releasing analogue (GnRHa, Buserelin) and pulsatile administration of hMG (Group I) were used to induce ovulation in nine patients with polycystic ovary syndrome (PCO). The same patients were also treated with pulsatile hMG administration alone (Group II). Ovulation was observed in all twelve treatment cycles in Group I, and there were two pregnancies. In Group II, ovulation occurred in 22 of 26 treatment cycles. Ovarian hyperstimulation occurred in one cycle of Group I and in 5 of 26 cycles of Group II. The total dose per cycle of hMG to induce ovulation in Group I was significantly lower than that needed when only pulsatile hMG administration was used. In response to Buserelin administration, the concentrations of serum luteinizing hormone (LH) and follicle stimulating hormone (FSH) increased transiently and then declined to the normal range observed in the early follicular phase. The concentrations of FSH increased in response to hMG administration, resulting in a normal LH/FSH ratio. The present data demonstrated that pulsatile subcutaneous administration of hMG in addition to Buserelin was effective in inducing follicular maturation and ovulation in patients with PCO with a lower incidence of serious side-effects.

Induction of Ovulation with Pulsatile Subcutaneous Administration of Human Menopausal Gonadotropin in Patients with Polycystic Ovary Syndrome

“…Pulsatile subcutaneous administration of hMG has been shown to be effective in inducing follicular matura tion and ovulation in patients with various types of an ovulatory infertility [7,10,13]. The present study has also demonstrated a high rate (89.2%) of ovulation induction with pulsatile administration of hMG or FSH in patients with PCOS.…”

“…The administration of Buserelin resulted in continued suppression of serum LH and FSH following the initial rise [10,15]. Fleming et al [15,16] demonstrated that the characteristics of ovarian responsiveness to exoge nous gonadotropins were unchanged after suppression of LH with Buserelin in patients with PCOS.…”

“…Treatment with a combination o f GnRH analogue and pulsatile administration o f hMG was used to induce ovulation in 9 patients (cases 1-5 and 7-11) [10]. Following progesterone (25 mg; Oophomin Luteum.…”