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[Pulsatile administration of GnRH: from the future to the present]
J C Thalabard1, G Plu, G Thomas
1INSERM U 292, Hôpital de Bicêtre, Le Kremplin, Bicêtre.
Abstract:
Since the first clinical reports of the successful induction of ovulations and pregnancies using pulsatile administration of the neuropeptide GnRH by G. Leyendecker and L. Wildt's group in 1979, the role of the hypothalamic generator, as demonstrated in primates by E. Knobil, is widely accepted in human reproduction. During this time, an increasing number of group has experienced these therapies and there continues to be some controversies about the route of administration, the indications, the need for adjuvant therapies. A correct evaluation of these therapies needs multicentric studies and more accurate criteria: the MINITEL network provides a fast, inexpensive way to collect data from different groups and to perform studies with larger sample sizes. The Life table analysis method represents the more suitable method for evaluating and for comparing various therapy regimens. LH plasma pulsatility studies have been performed in humans in order to classify various "supra-pituitary" reproductive disorders. These studies are exposed to several methodological drawbacks and must be cautiously interpreted. Modelling is one of the new methodological issues which can give access to more physiological parameters.