Prospective, randomized comparison between pulsatile GnRH therapy and combined gonadotropin (FSH+LH) treatment for ovulation induction in women with hypothalamic amenorrhea and underlying polycystic ovary syndrome

Eur J Obstet Gynecol Reprod Biol. 2013 May;168(1):45-8. doi: 10.1016/j.ejogrb.2012.12.016. Epub 2013 Jan 5.

Abstract

Objective(s): To compare the efficacy of pulsatile GnRH therapy versus combined gonadotropins for ovulation induction in women with both hypothalamic amenorrhoea and polycystic ovarian syndrome (HA/PCOS) according to their current hypothalamic status.

Study design: This single-centre, prospective, randomized study was conducted in the Nantes University Hospital, France. Thirty consecutive patients were treated for ovulation induction with either pulsatile GnRH therapy or combined gonadotropins (rFSH+rLH). Frequency of adequate ovarian response (mono- or bi-follicular) and clinical pregnancy rate were then compared between both groups.

Results: Ovarian response was similar in both groups with comparable frequency of adequate ovarian response (73% vs 60%), but the clinical pregnancy rate was significantly higher in the pulsatile GnRH therapy group than in the combined gonadotropin group (46% vs 0%).

Conclusions: HA/PCOS is a specific subgroup of infertile women. Pulsatile GnRH therapy is an effective and safe method of ovulation induction that can be used successfully in these patients.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Amenorrhea / drug therapy*
  • Amenorrhea / etiology
  • Drug Combinations
  • Female
  • Follicle Stimulating Hormone / administration & dosage*
  • Gonadotropin-Releasing Hormone / administration & dosage*
  • Humans
  • Hypothalamic Diseases / complications
  • Hypothalamic Diseases / drug therapy
  • Luteinizing Hormone / administration & dosage*
  • Ovulation Induction / methods*
  • Polycystic Ovary Syndrome / complications*
  • Polycystic Ovary Syndrome / drug therapy
  • Pregnancy
  • Pregnancy Rate

Substances

  • Drug Combinations
  • Gonadotropin-Releasing Hormone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone