{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:47:42Z","timestamp":1778154462639,"version":"3.51.4"},"reference-count":20,"publisher":"BMJ","issue":"6676","license":[{"start":{"date-parts":[[1989,3,25]],"date-time":"1989-03-25T00:00:00Z","timestamp":606787200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1989,3,25]]},"abstract":"<jats:p>OBJECTIVE--To review treatment with pulsatile luteinising hormone releasing hormone in infertile women who do not ovulate and are resistant to clomiphene after 100 pregnancies achieved with this treatment. DESIGN--Retrospective analysis of 146 courses of treatment over 434 cycles. SETTING--Infertility clinic. PATIENTS--118 Women whose failure to ovulate was due to idiopathic hypogonadotrophic hypogonadism (n = 39), amenorrhoea related to low weight (n = 17), organic pituitary disease (n = 15), or polycystic ovaries (n = 47). INTERVENTIONS--Dose of 15 micrograms luteinising hormone releasing hormone\/pulse subcutaneously every 90 minutes given with a miniaturised pump throughout cycle monitored by ultrasound. Women with hypogonadotrophic hypogonadism had 48 courses, women with amenorrhoea related to low weight 23, women with organic pituitary disease 18, and women with polycystic ovaries 57. END POINT--Follow up of 100 pregnancies achieved in 77 women during six years after introducing treatment. MEASUREMENTS and main results--One hundred pregnancies (seven multiple, 28 miscarriages). Cumulative rates of pregnancy were 93-100% at six months in women with idiopathic hypogonadotrophic hypogonadism, amenorrhoea related to low weight, and organic pituitary disease. In women with polycystic ovaries (cumulative rate of pregnancy 74%) adverse prognostic factors were obesity, hyperandrogenism, and high luteinising hormone concentrations, which were also associated with a high rate of early pregnancy loss. CONCLUSIONS--Treatment with pulsatile luteinising hormone releasing hormone is safe, simple, and effective, and the preferred method of inducing ovulation in appropriately selected patients. Compared with exogenous gonadotrophin treatment there is little need for monitoring, no danger of hyperstimulation, and a low rate of multiple pregnancies.<\/jats:p>","DOI":"10.1136\/bmj.298.6676.809","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"809-812","source":"Crossref","is-referenced-by-count":85,"title":["One hundred pregnancies after treatment with pulsatile luteinising hormone releasing hormone to induce ovulation."],"prefix":"10.1136","volume":"298","author":[{"given":"R.","family":"Homburg","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Eshel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. A.","family":"Armar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Tucker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. W.","family":"Mason","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Adams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Kilborn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. A.","family":"Sutherland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. 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Horm Res 1975;6:268-87.","journal-title":"Horm Res"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1210\/jcem-51-5-1214","article-title":"Pregnancies following chronic intermittent (pulsatile) administration of GnRH by means of a portable pump (-Zvklomat-)-a new approach to the treatment of infertilitv in hypothalamic amenorrhoea","volume":"51","author":"Leyendecker, G.; W'ildt, L.; Hansmann, M.","year":"1980","unstructured":"Leyendecker G, W'ildt L, Hansmann M Pregnancies following chronic intermittent (pulsatile) administration of GnRH by means of a portable pump (-Zvklomat-)-a new approach to the treatment of infertilitv in hypothalamic amenorrhoea. 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FertilSiernl 1988;49:956-60.","journal-title":"FertilSiernl"},{"key":"ref_6","first-page":"54","article-title":"Induction of fertility its patients with organic hypothalamic-pituitary disease: response to treatment with LHRH","volume-title":"Fertil Steril","volume":"47","author":"Miorris, D.V.; Abdulwahid, N.A.; Armar, N.A.; Jacobs, H.S.","year":"1987","unstructured":"Miorris DV, Abdulwahid NA, Armar NA, Jacobs HS. Induction of fertility its patients with organic hypothalamic-pituitary disease: response to treatment with LHRH. Fertil Steril 1987;47:54-9."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/S0140-6736(85)92552-8","article-title":"Mlultifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotrophin releasing hormone","volume":"ii:","author":"Adams, J.; Franks, S.; Poison, D.W.","year":"1985","unstructured":"Adams J, Franks S, Poison DW', et al. Mlultifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotrophin releasing hormone. Lancet 1985;ii: 1375-8.","journal-title":"Lancet"},{"key":"ref_8","first-page":"129","article-title":"A miniature infuser for the pulsatilc administration of LHRH","volume":"6","author":"Sutherland, I.A.; White, S.; Chambers, G.R.","year":"1984","unstructured":"Sutherland IA, White S, Chambers GR, et al. A miniature infuser for the pulsatilc administration of LHRH. 7 Biochem E'ng 1984;6:129-33.","journal-title":"7 Biochem E'ng"},{"key":"ref_9","first-page":"429","article-title":"Practical aspects of pulsatile LHRH therapy","volume":"37","author":"Armar, N.A.; Tan, S.L.; Eshel, A.; Jacobs, H.S.; Adams, J.; Sutherland, I.A.","year":"1987","unstructured":"Armar NA, Tan SL, Eshel A, Jacobs HS, Adams J, Sutherland IA. Practical aspects of pulsatile LHRH therapy. 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Fertil Steril 1988;49:52-5."},{"issue":"53","key":"ref_11","first-page":"1","article-title":"Fertility and infertility statistics: their importance and application","volume":"8","author":"Cooke, I.D.; Sulaiman, R.A.; ILenton, E.A.; Parsons, R.J.","year":"1981","unstructured":"Cooke ID, Sulaiman RA, ILenton EA, Parsons RJ. Fertility and infertility statistics: their importance and application. Clin O)bstet Gvnaecol 1981;8: 53 1-48.","journal-title":"Clin O)bstet Gvnaecol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1136\/bmj.297.6655.1024","article-title":"The influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in patients with polycystic ovary syndrome","volume":"297","author":"Homburg, R.; Armar, N.A.; Eshel, A.; Adams, J.; Jacobs, H.S.","year":"1988","unstructured":"Homburg R, Armar NA, Eshel A, Adams J, Jacobs HS. The influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in patients with polycystic ovary syndrome. Br MedJ 1988;297: 1024-6.","journal-title":"Br MedJ"},{"key":"ref_13","first-page":"99","article-title":"Induction of ovulation in women using pulsatile LHRH -clinical results","volume-title":"Therapeuitc applications oJ'LHRH","author":"Jacobs, H.S.","year":"1986","unstructured":"Jacobs HS. Induction of ovulation in women using pulsatile LHRH -clinical results. In: Bloom SR, Jacobs HS, eds. Therapeuitc applications oJ'LHRH. London: Royal Society of Medicine Sersices, 1986:99-109."},{"key":"ref_14","first-page":"473","article-title":"TIhe physiology of gonadotropin-releasing hormone (GnRH) secretion in men and women","volume":"41","author":"Crowlev, W.F.; Filicori, A.M.; Spratt, D.I.; Santoro, N.F.","year":"1985","unstructured":"Crowlev WF, Filicori AM, Spratt DI, Santoro NF. 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