Side effects of pulsatile GnRH therapy for induction of ovulation

Abstract

Pulsatile administration of GnRH by means of a portable pump is an efficient and practical method for the induction of ovulation as a treatment of infertility in hypothalamic amenorrhea. It represents a replacement therapy based on physiological observations. Since the feedback mechanisms between the ovary and pituitary gland remain intact, it is associated with a very low risk of multiple follicular development and multiple pregnancies. However, the results obtained with this method are critically dependent upon the correct selection of patients as far as the diagnosis of hypothalamic amenorrhea is concerned. If this is the case, pulsatile GnRH therapy is safe, associated with a very low risk of multiple pregnancy and, therefore, has to be considered as the therapy of choice in hypothalamic amenorrhea. © 2008 Expert Reviews Ltd.