Ovulation induction and pregnancy in women with hypothalamic amenorrhea treated with intermittent gonadotropin-releasing hormone

We induced ovulation in 34 cycles in 16 women following the administration of gonadotropin-releasing hormone (GnRH). In two patients two control cycles were induced. The patients self-administered GnRH through an indwelling intravenous catheter every 2 hours for 18 hours per day. In subsequent cycles the dose interval, dosage and infusion site, intravenous or subcutaneous, were varied. In all patients the estradiol, follicle-stimulating hormone and luteinizing hormone were measured, and follicular development was assessed ultrasonographically. Based on this preliminary study, a total of 34 cycles were studied in 16 women treated with 10 mg of self-administered GnRH intravenously every two hours during the day. Apparent ovulation was documented in all 34 cycles, and 11 pregnancies occurred. It appears that self-administered GnRH is economical and safe and achieves satisfactory results with respect to both ovulation and pregnancy.