[Induction of ovulation with subcutaneous pulsatile administration of human menopausal gonadotropin]

Induction of ovulation with subcutaneous pulsatile (every 90 min.) administration of HMG (Pergonal) 75 or 150 IU/day using a portable pump (Nipro SP-3I) was performed in 3 PCO patients (6 cycles), 4 first grade amenorrhea (Am-I) patients (7 cycles) and 4 Am-II patients (4 cycles). All patients ovulated except one cycle of Am-I patients and one PCO woman conceived. In regard to the duration of administration and the total dose of HMG until ovulation, the administration of 150 IU/day (M +/- SD=15.2 +/- 5.0 days, 2280 +/- 774 IU) is superior to 75 IU/day (39.5 +/- 11.4 days, 3900 +/- 1357 IU), and there was no significant difference between this method and the daily intramuscular injection of HMG. The group treated with HCG in the luteal phase revealed a longer luteal phase (14.0 +/- 2.3 days) than the nontreated group (12.6 +/- 1.5 days). Ovarian hyperstimulation was observed in one case and subsided spontaneously after admission. There were no other side effects. In conclusion, this method has the following advantages: A high ovulation rate, comparable with daily intramuscular administration. It is a less painful procedure than daily intramuscular injection. It is possible for the patient to lead normal life, insertion and removal being easily done by herself.