1992 Fiscal Year Final Research Report Summary
Induction of ovulation with pulsatile subcutaneous administration of menopausal gonadotropin in anovulatory infertile women.
| Project/Area Number |
02454388
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Obstetrics and gynecology
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| Research Institution | Kyorin University School of Medicine |
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Principal Investigator |
NAKAMURA Yukio Kyorin University School of Medicine, Department of OB/GYN, Professor, 医学部 (60051512)
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| Project Period (FY) |
1990 – 1992
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| Keywords | pulsatile administration / multiple pregnancy / gonadotropin / ovulation induction / luteal function |
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| Research Abstract |
The pulsatile subcutaneous administration of human menopausal gonadotropin (hMG) was used for induction of ovulation in patients with anovulatory infertile women. Ovulation was observed in 90.6% of 128 treatment cycles, and 16 (18 treatment cycles) of 26 patients became pregnant. All 16 fetus, excluding two pregnancies interrupted spontaneously, were sigleton conceptions. Ovarian hyperstimulation was observed in 15.6% of treatment cycles. In the second experiment, treatment with a combination of gonadotropin releasing hormone agonist (GnRHa) and pulsatile administration of hMG was used to induce ovulation in patients with polycystic ovary syndrome (PCO). GnRHa administration, permit manipulation and alteration of the levels of LH and FSH, resulting in normalization of the LH/FSH ratio. This may lessen the risk of ovarian hyperstimulation. The final experiment was undertaken to assess the clinical relevance of daily hormonal changes for achieving a successful pregnancy in anovulatory in
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fertile women. Up to the mid-luteal phase progesterone (P) and estradiol (E_2) values in non-pregnant cycles did not differ significantly from those in pregnant cycles. However, the P/E_2 ratio in the mid-luteal phase was significantly greater in pregnant cycles than in the non-pregnant cycles, suggesting that the P/E_2 ratio is a more important indicator of hormonal function for implantation than the absolute levels of either P or E_2. A premature endogenous LH rise and premature luteinization were frequent phenomena in anovulatory infertile women undergoing the pulsatile administration of hMG. However, the incidences in the pregnant cycles were comparable to those in non-pregnant cycles, suggesting that the occurrence of premature luteinization may not necessarily be detrimental to the establishment of successful pregnancy.
The present study demonstrate that pulsatile subcutaneous administration of hMG is effective in induction of successful ovulation and establishment of singleton pregnancy in patients with anovulatory infertility. Less
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