An-ovulatory Infertility
Ovulation induction is the method for treating An-ovulatory Infertility.
Hypogonadotrophic Hypogonadism (Hypothalamic-Pituitary Cause)
· Treatment involves administration of both Follicle stimulating Hormone and Lutinising Hormone, while Human Chorionic Gonadotrophin is injected for follicle rupture.
· Pulsatile Gonadotrophin Releasing Hormone has the same effectiveness as Gonadotrophins with the advantage of low multiple pregnancy rates.
PolyCystic Ovary Syndrome PCOS
· First treatment of choice is Clomiphene Citrate CC. In properly selected PCOS patients, the cumulative pregnancy rate using CC approaches that of normal women.
· Low-dose Follicle stimulating Hormone protocols are the second line of treatment and are effective in inducing monofollicular development.
· Laparoscopic Ovarian Drilling can be an alternative but not as a first choice treatment in Clomiphene Citrate-Resistant patients.
· Pulsatile GnRH and GnRH agonists, are hardly used today in PCOS.
· In obese women with PCOS, weight loss and exercise should be recommended as the first line of therapy.
· Aromatase Inhibitors are not necessarily helpful PCOS.
· Insulin Sensitizers can help if added to CC in obese PCOS patients.