Low-dose human chorionic gonadotropin therapy can improve sensitivity to exogenous follicle-stimulating hormone in patients with secondary amenorrhea

Objective: To assess the effect of supplementing an ovulation induction regimen of highly purified FSH with LH activity in the form of low-dose hCG therapy. Design: Case report. Setting: The Reproductive Endocrinology Center at the University of Bologna, Bologna, Italy. Patient(s): A woman with weight-related secondary hypogonadotropic amenorrhea. Intervention(s): The patient was treated first with highly purified FSH alone and then received highly purified FSH in combination with low-dose hCG therapy (50 IU/d). Main Outcome Measure(s): Pelvic ultrasound examinations, serum E-2 levels, duration of treatment, total dose of highly purified FSH, and outcome of treatment. Result(s): The concomitant administration of low-dose hCG and highly purified FSH markedly reduced the duration of treatment and the dose of highly purified FSH, and resulted in a quadruplet pregnancy in a patient in whom several previous ovulation induction procedures had been unsuccessful. Conclusion(s): Supplementation of an ovulation induction regimen with an agent that has LH activity can enhance FSH-induced folliculogenesis and markedly reduce costs in women with hypogonadotropic hypogonadism. However, this increased response can be associated with complications such as multiple gestation. (Fertil Steril(R) 1999;72:1118-20. (C) 1999 by American Society for Reproductive Medicine).