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Ovulation induction with pulsatile human menopausal gonadotropin (HMG) administration
1Department of Obstetrics and Gynecology, Bikur Cholim Hospital, Jerusalem, Israel.
Summary
Pulsatile administration of human menopausal gonadotropin (HMG) effectively induces ovulation in infertile women resistant to conventional treatments. This method offers a viable alternative, achieving significant ovulation and pregnancy rates with minimal risk of overstimulation.
Area of Science:
- Reproductive Endocrinology
- Infertility Treatment
- Hormone Therapy
Background:
- Anovulatory infertility presents a significant challenge, particularly in cases resistant to standard treatments.
- Conventional regimens for ovulation induction can lead to ovarian overstimulation syndrome (OSS).
Observation:
- A computerized pump delivered continuous pulsatile human menopausal gonadotropin (HMG) to 5 patients with prolonged anovulatory infertility over 14 cycles.
- Patients had previously failed standard treatments or experienced recurrent OSS.
Findings:
- Ovulation was detected in 12 of 14 cycles (85.7%) via hormonal and ultrasonic evaluation.
- Pregnancy was achieved in 2 of 5 cases (40%).
- Mild ovarian overstimulation occurred in only 3 of 14 cycles (21.4%).
Implications:
- Pulsatile HMG administration is an effective alternative for inducing ovulation when conventional methods fail.
- This approach demonstrates favorable ovulation (75%) and pregnancy (23.5%) rates across combined series.
- It offers a safer alternative with a reduced risk of severe ovarian overstimulation syndrome.