Induction of Ovulation with Pulsatile Subcutaneous Administration of Human Menopausal Gonadotropin in Patients with Polycystic Ovary Syndrome

Abstract

The present study was undertaken to determine whether ovulation can be induced in patients with polycystic ovary syndrome (PCOS) by pulsatile subcutaneous administration of hMG after the pituitary secretion of LH and FSH was suppressed with a gonadotropin releasing hormone (GnRH) analogue. The results of the combined regimen cycles (group II) were compared with those of hMG (group I) or FSH (group III) pulsatile administration in the same PCOS patients. The ovulation rate (89.1 % of 46 cycles) in group I was significantly greater (p < 0.01) than that found in group II (65.9% of 41 cycles). In group III, ovulation occurred in 89.5% of the 19 treatment cycles. Ovarian hyperstimulation syndrome (OHSS) occurred in 28.3% of cycles in group I, 7.3% in group II, and 26.3% in group III, respectively. The incidence of OHSS in group II was significantly lower than that found in group I or III. The rates of pregnancy were 10.9 % of cycles in group I, 4.9 % in group II, and 21.1 % in group III, respectively. All 10 fetuses were singleton conceptions, and the pregnancies continued successfully to term. The present data demonstrate that pulsatile subcutaneous administration of hMG or FSH is effective in the induction of successful ovulation and the establishment of singleton pregnancy in patients with PCOS.