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Drug: Gonadotrophin Releasing Hormone (GnRH or LHRH)

When is Gonadotrophin (GnRH) releasing hormone required 

The area of the brain above the pituitary gland is known as the hypothalamus. GnRH is released from the normal hypothalamus. This, in turn, stimulates the release of both F.S.H. and L.H. from the pituitary. Sometimes the hypothalamus fails to function normally. As a result there is an inadequate stimulus to the pituitary to secrete F.S.H. and L.H. Giving GnRH is therefore a logical treatment for these patients. 

Are there any side effects of GnRH

The incidence of multiple pregnancies is not significantly higher than for the general population and hyperstimulation has not been reported.

How is GnRH administered

GnRH is administered via a small automatic pump. The patient has to wear this pump night and day usually in a holster under the arm. The pump is set to deliver a 15 mg dose of GnRH every 90 minutes. The hormone is given under the skin via a small needle, the site of which is changed by the patient every 48 hours. The drawbacks of this treatment are the discomfort of wearing the pump round the clock and the expense. 

How is this treatment monitored for success

The response to treatment is monitored using ultrasound, if available, or by keeping a check on the hormone levels of F.S.H., L.H., estrogen and progesterone. A pregnancy should occur within 6 cycles of treatment if the failure of the hypothalamus is the sole cause for infertility.

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