Induction of ovulation in hypothalamic amenorrhoea with gonadotrophin releasing hormone

The use of gonadotrophin releasing hormone (GnRH) to induce ovulation in clomiphene-unresponsive hypothalamic amenorrhoea (HA) has a major advantage over gonadotrophin therapy in leaving the ovarianpituitary feedback loop intact, minimizing the risk of multiple ovulation and ovarian hyperstimulation. Since recognition of the need for a pulsatile mode of administration, it has been shown that intravenous (i.v.) pulsatile GnRH is able to induce fertile ovulation. Because of the inconvenience and dangers of the i.v. route, we have examined the feasibility of subcutaneous (s.c.) GnRH for ovulation induction in HA.