[Subcutaneous long-term pulsatile administration of LH-RH to patients with hypothalamic amenorrhea]

The effects of pulsatile LH-RH administration on ovulation induction and luteal phase activity were studied in 8 women with hypothalamic amenorrhea (2, with primary amenorrhea and 6 with secondary). Ten to 20 micrograms of LH-RH was subcutaneously injected by autoinfusion pump every 2 hours for more than 56 days. Six out of 8 women responded to the treatment and showed a total of 18 ovulatory cycles. The mean length of the follicular and luteal phases was 25.9 +/- 6.37 days and 11.9 +/- 0.43 days, respectively. The serum progesterone level in mid luteal phase was 12.0 +/- 2.35 ng/ml and was in the normal range for naturally cycling women. Two patients with secondary amenorrhea conceived in the 2nd and 3rd ovulatory cycle, respectively. In two patients who showed no response to LH-RH pulsatile administration for 56 days of treatment, serum LH and FSH levels were gradually lowered and the response to 100 micrograms of LH-RH iv injection was remarkably attenuated, suggesting that the pituitary gland was desensitized by the treatment.