We administered pulsatile low doses of gonadotropin-releasing hormone (GnRH) (1 to 5 μg) to patients whose anovulation was caused by relative and absolute deficiency of endogenous GnRH. Eight such patients, including one 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 minutes. 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 three cycles were anovulatory. All patients responded, and five (62%) of the eight conceived, for a total of seven pregnancies and four full-term deliveries of normal infants. This study demonstrates that small pulsatile doses of GnRH can activate cyclic pituitary-ovarian function in hypogonadotropin-acyclic women and induce ovulation resulting in pregnancy and live birth.
Miller DS, Reid RR, Cetel NS, Rebar RW, Yen SSC. Pulsatile Administration of Low-Dose Gonadotropin-Releasing Hormone: Ovulation and Pregnancy in Women With Hypothalamic Amenorrhea. JAMA. 1983;250(21):2937–2941. doi:10.1001/jama.1983.03340210035021
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