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A 'sweet' indication for ovulation induction.

In diabetic patients, euglycaemia at the time of conception is crucial for the success of the pregnancy. In consideration of the difficulty in achieving and maintaining tight glycaemic control for long periods, we administered clomiphene citrate, which is usually indicated in cases of absent or infrequent ovulation, to enhance fecundability in 10 pregestational diabetic patients. All conceived within one to three cycles of the drug, and nine delivered healthy term babies after uneventful pregnancies; one aborted spontaneously in the eighth gestational week. No effect of the drug on the diabetes was noted as based on measurements of glycosylated haemoglobin and fructosamine concentrations and the absence of changes in the patients' insulin requirements. In the light of these successful results, and in view of the importance of euglycaemia at the beginning of diabetic pregnancies, we suggest a new 'sweet' indication for the use of clomiphene citrate.

Adult↗

Ovulation induction with pulsatile gonadotropin-releasing hormone administration in patients with polycystic ovarian syndrome.

Gonadotropin-releasing hormone (0.025 microgram/kg) was administered intravenously in a pulsatile fashion to four subjects with polycystic ovary syndrome for a total of six cycles. Five of the six cycles culminated in ovulation, although in one course the response occurred too early to be attributed to the therapy alone. No pregnancies resulted. All luteal phases were of normal duration, but progesterone production as manifested by serum progesterone determination was deficient in some. If additional investigation confirms these preliminary findings, this form of therapy may offer a safe and economic alternative for anovulatory patients refractory to clomiphene citrate therapy. The response of the four subjects suggests that pulsatile gonadotropin-releasing hormone administration may override hypothalamic-pituitary dysfunction and result in ovulatory menstrual cycles.

Adult↗