[Ovulation induction with gonadotropins aided by cervix mucus analysis and echography]

Area of Science:

• Reproductive Endocrinology
• Infertility Treatment

Background:

• Anovulation affects numerous women, necessitating effective ovulation induction therapies.
• Human menopausal gonadotropins (HMG) are commonly used but require careful monitoring.
• Previous protocols often involve intensive hormonal monitoring and advanced technology.

Purpose of the Study:

• To evaluate the efficacy and safety of HMG for ovulation induction in patients with anovulation.
• To assess the feasibility of using high-resolution ultrasound as the primary monitoring tool, minimizing hormonal assays.
• To compare outcomes with existing literature on ovulation induction.

Main Methods:

• 148 cycles of ovulation induction using HMG were administered to 52 patients with hypothalamic-pituitary dysfunction.
• Follicular development was monitored using clinical assessment of cervical mucus and ovarian ultrasound from day eight.
• Human chorionic gonadotropin (HCG) was administered when follicles exceeded 14 mm.

Main Results:

• A 44% pregnancy rate (25 pregnancies in 23 patients) was achieved.
• 19 healthy babies were delivered; complications included neonatal deaths, miscarriages, and ectopic pregnancy.
• Multiple gestations occurred in 12% of pregnancies, and ovarian hyperstimulation syndrome (OHS) in 13.4%.

Conclusions:

• Ovulation induction with HMG is a viable treatment for anovulation, yielding comparable results to other series.
• High-resolution ultrasound is a sufficient tool for monitoring follicular development, reducing the need for daily hormone level measurements.
• The procedure requires strict clinical vigilance despite technological advancements.