Experience with combined individualized method of hMG/hCG therapy

The introduction of powerful ovulation induction agents, such as gonadotropins, has made an important contribution to the temporary elimination of the anovulation syndrome. Since the treatment is expensive and not without significant medical complication, it is vitally important to conduct therapy according to a well-defined monitoring system. In the past, clinicians have tended to monitor gonadotropin therapy by biophysical signs, but they were found to be insufficient monitors if used alone. Estrogen secretion from the ovaries does reflect the follicular maturation process. In this study a combined individualized method for hMG/hCG therapy is presented. Fifty-one infertile anovulatory women were treated for a total of 124 treatment cycles. All courses of therapy were judged to have induced ovulation. There was a good clinical correlation between cervical score and increasing estrogen levels. The pregnancy rate was 62.7%, with 60% of patients becoming pregnant within the first three cycles of treatment. In spite of the complications of less than 1% of severe hyperstimulation, 15.5% multiple gestation, and 28% of abortion rate, gonadotropin therapy is a most efficient tool in the treatment of infertility due to anovulation.