In the normal menstrual cycle, the functional integrity of the hypothalamic-pituitary-ovarian axis requires the pulsatile secretion of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This hypothalamic hormone, also known as luteinizing hormone-releasing hormone, stimulates pituitary gonadotropin (luteinizing hormone and follicle-stimulating hormone) secretion, promoting ovarian follicular maturation, ovulation, and corpus luteum function.1,2 When the hypothalamus fails to provide an appropriate GnRH stimulation of the pituitary gland, anovulatory infertility often occurs. Recent advances in neuroendocrine physiology demonstrate that pulsatile GnRH replacement therapy can restore ovulation and fertility. Infertility specialists are learning how to provide pulsatile GnRH therapy for the treatment of hypothalamic hypogonadism in both men and women.3-5 Recent evidence also suggests that higher-dose pulsatile GnRH treatment may be used to achieve multiple follicular growth for in vitro fertilization therapy, when the collection of several mature oocytes is desired.6
Sopelak VM, Williams RF, Aso T, Marut EL, Hodgen GD. A Mechanical 'Hypothalamus' for Ovulation Induction Therapy. JAMA. 1984;251(11):1477. doi:10.1001/jama.1984.03340350067033
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