[Pregnancy outcomes following pulsatile GnRH treatment: results of a large multicenter retrospective study]. / Grossesses obtenues par administration pulsatile de GnRH: résultats d'une large étude rétrospective multicentrique.

OBJECTIVES: The aim of the present study was to evaluate the efficacy of pulsatile GnRH treatment in a large French cohort of patients with hypogonadotropic hypogonadism. METHODS: A retrospective study involving all women treated with pulsatile GnRH, over a 3-year period, in 24 French centers. Pregnancy rate and pregnancy outcome were the criteria for evaluation. RESULTS: The study included 248 women who received a total of 829 treatment cycles. The treatment routes of administration were subcutaneous (56.1% of the patients), intravenous (31.1%), or both (12.7%). The pregnancy rate per treatment cycle was 25%, while the mean number of cycles needed to obtain a pregnancy was 2.8+/-1.7. The miscarriage rate was 8.2% and the multiple pregnancy rates 8.8%. The mean delivery term was 38.4+/-2.4 weeks and the mean birth weight was 3009+/-561 g. No severe ovarian hyperstimulation was recorded. Ovarian cysts occurred in 2.3% of the treatment cycles, local allergies in 1.7%. CONCLUSION: Our study has shown that pulsatile GnRH treatment was well tolerated, without severe hyperstimulation. It induced a good pregnancy rate with favorable pregnancy outcomes.

[Informations for the infertile couple]. / Informations à donner au couple infécond.

The aim of the first consultation related to infertility is supposed to be the optimization of all factors that can increase the chances of pregnancy: more frequent sexual intercourse during the fertility windows; lifestyle modifications (better diet, decreased exposure to tobacco or other toxics); older couples can enjoy the same advice but should be proposed a quicker medical support. Maternal preconceptional advice must be transmitted. A testicular cancer must always be excluded in infertile men, while the risk of hormone-dependent cancers in infertile women remains undetermined. With the results of this first consultation, couples will generally be proposed the best solution to achieve their parental project: ovarian stimulation assisted reproductive technology (IUI, IVF or ICSI) or adoption.