The induction of ovulation by pulsatile administration of GnRH: an appropriate method in hypothalamic amenorrhea
The induction of ovulation by pulsatile administration of GnRH: an appropriate method in hypothalamic amenorrhea
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DOI：
10.1080/09513590.2017.1296948
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Gomez, Fulgencio
中科院分区：
文献类型：
--
作者：
Christou, Fotini;Pitteloud, Nelly;Gomez, Fulgencio
通过确保GnRH脉冲给药的泵诱导排卵是一种众所周知的方法，适用于患有下丘脑起源闭经的妇女。虽然这是确定生育能力的一种简单有效的方法，但没有得到充分利用。12例患有这种情况，1卡尔曼综合征，4个正常的孤立性低促性腺激素性性腺功能减退症，7功能性下丘脑闭经渴望怀孕的治疗。他们接受了一个或多个周期的脉冲式GnRH，频率为90分钟，通过静脉或皮下途径。初始剂量为静脉注射每次5 g，皮下注射每次15 g。通过定期给予促性腺激素、雌二醇和孕酮监测治疗，并通过阴道内超声检查监测卵泡发育和排卵。所有患者在平均17天的泵刺激后都有排卵记录。无论给药途径如何，33个治疗周期中有30个发生单次排卵。排卵导致7例患者中10例妊娠（其中3例2例妊娠），分布在3个诊断类别中。作为比较，一名PCOS患者接受了类似的治疗，但未排卵，LH峰过早出现。
The induction of ovulation by the means of a pump which assures the pulsatile administration of GnRH is a well-known method that applies to women suffering from amenorrhea of hypothalamic origin. Although a simple and efficient method to establish fertility, it is underused. Twelve patients suffering from this condition, 1 Kallmann syndrome, 4 normosmic isolated hypogonadotropic hypogonadism, and 7 functional hypothalamic amenorrhea desiring pregnancy were treated. They underwent one or more cycles of pulsatile GnRH, at a frequency of 90minutes, either by the intravenous or the subcutaneous route. An initial dose of 5g per pulse in the intravenous route was administered and of 15g per pulse in the subcutaneous route. The treatment was monitored by regular dosing of gonadotropins, estradiol and progesterone, and the development of follicles and ovulation was monitored by intra-vaginal ultrasonography. All the patients had documented ovulation, after a mean of 17days on pump stimulation. Single ovulation occurred in 30 of 33 treatment cycles, irrespective of the route of administration. Ovulation resulted in 10 pregnancies over 7 patients (2 pregnancies in 3 of them), distributed in the 3 diagnostic categories. For comparison, a patient with PCOS treated similarly, disclosed premature LH surge without ovulation.