Exogenous progesterone for luteal support following gonadotropin-releasing hormone ovulation induction: Case report

Intravenous or subcutaneous pulsatile administration of gonadotropin-releasing hormone (GnRH) has been successfully used to induce ovulation in anovulatory women. This form of ovulation induction is more physiologic, more easily monitored, less likely to result in hyperstimulation or multiple gestations, and possibly less expensive than the use of menopausal gonadotropins. The postovulatory management of the luteal phase in women given GnRH has varied in previously reported clinical studies. Most commonly, either continuation of GnRH at the same dosage and frequency used to induce ovulation is given during the luteal phase, or discontinuation of GnRH followed by intramuscular human chorionic gonadotropin (hCG) has been used. A case of primary infertility in which the wife evidenced anovulation unresponsive to clomiphene citrate (CC) therapy is presented. Successful ovulation induction by intermittent pulsatile subcutaneous GnRH administration followed by luteal phase support with vaginal progesterone (P) suppositories alone were provided. A midtrimester pregnancy is presently ongoing.