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[Pregnancy outcomes following pulsatile GnRH treatment: results of a large multicenter retrospective study]
S Christin-Maitre1, M de Crécy,
1Service d'Endocrinologie, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, 184, rue du Faubourg-Saint-Antoine, Université Paris-VI, UPRES 1533, 75012 Paris cedex, France. sophie.christin-maitre@sat.aphp.fr
Objectives:
The aim of the present study was to evaluate the efficacy of pulsatile GnRH treatment in a large French cohort of patients with hypogonadotropic hypogonadism.
Methods:
A retrospective study involving all women treated with pulsatile GnRH, over a 3-year period, in 24 French centers. Pregnancy rate and pregnancy outcome were the criteria for evaluation.
Results:
The study included 248 women who received a total of 829 treatment cycles. The treatment routes of administration were subcutaneous (56.1% of the patients), intravenous (31.1%), or both (12.7%). The pregnancy rate per treatment cycle was 25%, while the mean number of cycles needed to obtain a pregnancy was 2.8+/-1.7. The miscarriage rate was 8.2% and the multiple pregnancy rates 8.8%. The mean delivery term was 38.4+/-2.4 weeks and the mean birth weight was 3009+/-561 g. No severe ovarian hyperstimulation was recorded. Ovarian cysts occurred in 2.3% of the treatment cycles, local allergies in 1.7%.
Conclusion:
Our study has shown that pulsatile GnRH treatment was well tolerated, without severe hyperstimulation. It induced a good pregnancy rate with favorable pregnancy outcomes.