Follow-up of 32 hypothalamo-hypopituitary patients treated with pulsatile gonadotropin-releasing hormone or human menopausal gonadotropin

In a clinical retrospective study, a follow-up of hypothalamo-amenorrheic p atients treated firstly with gonadotropin-releasing hormone (GnRH) pump sti mulation and secondly with human menopausal gonadotropin (hMG) was performe d. Thirty-two hypothalamo-amenorrheic patients, 24-38 years old, were submi tted to 103 GnRH stimulation cycles. Seven, with polycystic ovaries (PCO) o n ultrasound, were stimulated with hMG after one or several unsuccessful pu mp cycles. Ovulation was confirmed by a luteinizing hormone (LH) surge or triggered by human chorionic gonadotropin in 80 out of 103 cycles (77.7%/cycle) leading to 62 timed sexual intercourses and 17 intrauterine inseminations (IUI). T wenty-one pregnancies (26.3%/cycle) terminated in eight abortions (38.1%/pr egnancy) and 13 deliveries (40.6%/patient). hMG stimulation, in the seven P CO patients (six IVF, one IUI), led to four additional deliveries in three patients. Five patients became pregnant spontaneously after pump failure (n = 2) or unsuccessful IVF (n = 3). Combining all cycles, 17 deliveries were obtained in 16 patients. No case of ovarian hyperstimulation syndrome (OHS S) was observed. GnRH is an efficient and safe treatment of hypothalamo-amenorrheic-induced anovulation. Following GnRH or hMG ovarian stimulation, spontaneous ovulati on and conception may be restored in certain hypothalamo-amenorrheic patien ts.