[Induction of ovulation by a luteinizing hormone releasing hormone pump. Principles, indications and results]

A new treatment of hypothalamic amenorrhea is based mainly on Knobil's data demonstrating the physiological pulsatile secretion of GnRH. This hormone can be administered intravenously in a chronic intermittent (pulsatile) fashion. Nine women suffering from hypothalamic amenorrhea received 1 pulse of GnRH 5 to 20 micrograms every 90 minutes via a portable infusion pump. Nine pregnancies were induced after a mean 1.5 cycle. Three precocious miscarriages occurred. At this moment two children are born and four other pregnancies are undelivered. Venous tolerance was excellent, except in one patient who developed repeated venitis. Pulsatile administration of GnRH is very effective in inducing ovulation without risk of hyperstimulation frequently observed with HMG-hCG.