PULSATILE ADMINISTRATION OF GONADOTROPIN-RELEASING-HORMONE AND ORAL-ADMINISTRATION OF NALTREXONE IN HYPOTHALAMIC AMENORRHEA

Between 1979 and 1990, 73 patients suffering from hypothalamic amenorr hoea were treated by pulsatile administration of gonadotrophin releasi ng hormone (GnRH) in 359 treatment cycles. Seventy-two pregnancies wer e achieved. In 64 favourable patients in whom hypothalamic amenorrhoea constituted the only reason for infertility, a pregnancy rate of 29% per cycle could be obtained. Patients who conceived during pulsatile G nRH required an average of only 2.4 cycles per conception. Twelve out of 24 patients with hypothalamic amenorrhoea who exhibited an ovulator y response to pulsatile GnRH, ovulated during oral administration of n altrexone; such responsiveness to opioid antagonism was, however, rest ricted to the less serious grades. In conclusion, pulsatile administra tion of GnRH continues to be a highly effective mode of treatment of i nfertility due to hypothalamic amenorrhoea of various aetiologies. A s ubgroup of these patients may be successfully treated by the oral admi nistration of naltrexone.