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.

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