Administration of pure follicle-stimulating hormone during gonadotropin-releasing hormone agonist therapy in patients with clomiphene-resistant polycystic ovarian disease: hormonal evaluations and clinical perspectives

American Journal of Obstetrics and Gynecology
V RemorgidaL De Cecco

Abstract

Nine women with chronic anovulation caused by polycystic ovarian disease, which was unresponsive to clomiphene citrate therapy, were given a gonadotropin-releasing hormone agonist (buserelin) to induce pituitary desensitization. After 4 weeks induction of ovulation was attempted with a step-up administration of urinary follicle-stimulating hormone. Buserelin treatment was discontinued only in the presence of a positive pregnancy test result. Different responses were observed between the first and subsequent cycles. Whereas estradiol production and follicular growth were closely correlated in the first attempt, we recorded a dissociation between these two parameters of ovarian response during subsequent stimulations. Four clinical pregnancies occurred in these nine patients, and there was one abortion. This therapeutic approach can be successfully used to induce ovulation; however, prolonging pituitary suppression between treatment cycles changes the type of ovarian response and is not followed by better results.

References

Apr 1, 1969·The Journal of Obstetrics and Gynaecology of the British Commonwealth·J B BrownL Townsend

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Citations

Apr 25, 2000·Molecular and Cellular Endocrinology·C M Howles
Jun 1, 1993·Baillière's Clinical Obstetrics and Gynaecology·B C FauserD C Schoot
Feb 1, 1997·Endocrine Reviews·B C Fauser, A M Van Heusden

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