Pulsatile infusion of gonadotrophin releasing hormone (GnRH): investigative and therapeutic applications |
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| Institution: | 1. Department of Obstetrics and Gynaecology, St Mary''s Hospital Medical School, London W2 1PG, UK;2. Engineering Department, National Institute for Medical Research, Mill Hill, London NW7 1AA, UK;1. Department of Otolaryngology Head & Neck Surgery, Massachusetts Eye & Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA;2. Department of Otolaryngology–Head & Neck Surgery, Virginia Commonwealth University School of Medicine, PO Box 980146, Richmond, VA 23298-0146, USA;1. University of Milan, Faculty of Medicine, Milan, Italy;2. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy;1. Lund University Diabetes Centre, Malmö, Sweden;2. Department of Clinical Pathology, Ryhov Hospital, Jönköping, Sweden;3. Turku PET Centre, University of Turku, Turku, Finland;1. Department of Medicine, Division of Endocrinology, Diabetes and Hypertension, Brigham and Women''s Hospital and Harvard Medical School, USA;2. Harvard Program in Neuroscience. Boston, 02115, USA |
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| Abstract: | Normal gonadotrophin secretion, and therefore normal ovarian function, depend on delivery to the pituitary of the hypothalamic neuropeptide gonadotrophin releasing hormone (GnRH) in a pulsatile pattern. In the mid-follicular phase of the menstrual cycle, for example, discrete pulses of luteinizing hormone (LH) can be observed at approximately 90 min intervals. Many disorders of ovulation are caused by abnormalities of this natural pulsed signal. We have developed and used a small portable infusion pump to deliver GnRH to women with hypothalamic amenorrhoea; our studies, and those of other groups, have shown that successful ovulation and pregnancy result from such treatment. The results of treatment at St Mary's Hospital show that 16 women with hypogonadotrophic amenorrhoea received a total of 31 cycles of treatment with pulsatile GnRH; 25 (81%) of these cycles were ovulatory and 11 of the 14 women who were trying to conceive became pregnant. There was only one multiple pregnancy (twins). |
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