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Ovulation induction with human menopausal gonadotropins.

M P Diamond, A C Wentz

    Obstetrical & Gynecological Survey
    |August 1, 1986
    PubMed
    Summary
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    Human menopausal gonadotropin (hMG) stimulation of ovulation has evolved for various fertility issues. Current recommendations emphasize combined monitoring of serum estradiol (E2) and ultrasound to optimize ovulation induction and prevent complications.

    Area of Science:

    • Reproductive Endocrinology
    • Gynecology
    • Infertility Treatment

    Background:

    • Human menopausal gonadotropin (hMG) has a history of use in stimulating ovulation, particularly in amenorrheic individuals.
    • Understanding hMG's effects, monitoring, and complications has led to broader applications in fertility treatment.

    Purpose of the Study:

    • To review the historical use and evolution of hMG for ovulation induction.
    • To provide current recommendations for hMG use, incorporating advanced monitoring techniques.
    • To discuss the extension of hMG applications to other infertility conditions and in vitro fertilization (IVF).

    Main Methods:

    • Review of literature on hMG stimulation of ovulation.
    • Analysis of monitoring techniques including serum estradiol (E2) and ultrasound.

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  • Synthesis of principles for current clinical recommendations.

    • Main Results:

    • hMG use has expanded beyond amenorrhea to include cervical mucus deficiencies, luteal phase defects, and IVF.
    • Recommendations suggest achieving an "E2 window" of at least 1000 pg/ml over a 9- to 12-day follicular phase.
    • Combined assessment of serum E2 and ultrasound is crucial for monitoring.

    Conclusions:

    • Current hMG protocols should integrate both serum E2 and ultrasound monitoring.
    • Avoid premature human chorionic gonadotropin (hCG) administration based on a single monitoring modality.
    • Optimized monitoring strategies enhance the efficacy and safety of hMG-induced ovulation.