Chapter 15 - Ovulation induction for hypogonadotropic hypogonadism

Summary

Women with hypogonadotropic hypogonadism (HH) that have been treated with only follicle stimulating hormone (FSH) preparations required more menotropin ampoules and exhibited fewer pre-ovulatory follicles, lower estradiol levels and endometrial thickness, and reduced occurrence of ovulation. Ovarian hyperstimulation syndrome (OHSS) is the most serious iatrogenic complication associated with ovarian stimulation. In women undergoing ovarian stimulation with gonadotropins, human chorionic gonadotropin (HCG) is the usual trigger for OHSS. Women with hypopituitarism constitute a challenging and difficult-to-handle group of hypogonadotropic patients. The possible use of growth hormone (GH) as an adjunct to human menopausal gonadotropin (hMG) to induce ovulation has been the focus of extensive research. GH therapy may similarly improve the success of in vitro fertilization techniques by enhancing the hyperovulatory response to hMG. The long-acting follicle-stimulating hormone molecule corifollitropin alfa might reduce the injection frequency of gonadotropins to once per week, with pregnancy results similar to conventional gonadotropin.