Pulsatile administration of low-dose gonadotropin-releasing hormone. Ovulation and pregnancy in women with hypothalamic amenorrhea

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Abstract
Pulsatile low doses of gonadotropin-releasing hormone (GnRH) (1-5 .mu.g) were administered to patients whose anovulation was caused by relative and absolute deficiency of endogenous GnRH. Eight such patients, including 1 with previous pituitary stalk transection, were treated during a total of 23 cycles; pulses of GnRH were administered via a portable pump every 96 or 120 min. Activation of pituitary-ovarian function with orderly development of a single dominant follicle, a luteinizing hormone surge and ovulation occurred in 20 of the 23 cycles. The other 3 cycles were anovulatory. All patients responded, and 5 (62%) of the 8 conceived, for a total of 7 pregnancies and 4 full-term deliveries of normal infants. Small pulsatile doses of GnRH can activate cyclic pituitary-ovarian function in hypogonadotropin-acyclic women and induce ovulation resulting in pregnancy and live birth.

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