The use of human gonadotropins for the induction of ovulation in women with polycystic ovarian disease.

During the years 1974 to 1977, a total of 77 treatment cycles of human menopausal gonadotropin (hMG)-human chorionic gonadotropin (hCG) were administered to 41 infertile patients with polycystic ovarian disease who failed to conceive on clomiphene. Twenty-seven patients (65.9%) conceived, two of them twice, making twenty-nine pregnancies. The abortion rate was 24.1% and the multiple pregnancy rate was 36.3%. Of the 77 treatment cycles, 7.8% were complicated by mild hyperstimulation and 3.9% by severe hyperstimulation. In six treatment cycles (7.8%), ovulation occurred spontaneously prior to the hCG injection. hMG-hCG is an additional safe and effective, nonsurgical treatment for women with polycystic ovarian disease who have failed to respond to clomiphene therapy. The reaction to exogenous gonadotropins is unpredictable and probably depends on the stage of follicular development prior to the stimulation. Therefore, daily estrogen determinations from the 1st day of treatment are mandatory in order to avoid hyperstimulation and/or multiple births.