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Friday, 4 April 2014

Ovulation induction in special circumstances

In the introductory post on Ovulation induction, I had mentioned that there are some special circumstances where ovulation does not occur due to a problem in the hypothalamus. In the normal individuals, the hormones FSH and LH (the common term for these two together is Gonadotrophins) are released from the pituitary gland in brain and their role is to enable the growth of follicles in the ovary culminating in ovulation. This action of pituitary gland is controlled by another organ in the brain called hypothalamus with the help of hormones called Gonadotrophin releasing hormones. 

When the "circuitry" in the hypothalamus is faulty, the ovaries fail to work. There is no hormone producing activity in the ovary and so the cyclical growing and shedding of womb lining (menstrual cycle) does not occur. This condition is called Hypothalamic Hypomenorrhoea or Hypogonadotrophic hypogonadism (hypo hypo in short). Ovulation induction in such women can only be done by giving FSH and LH injections to artificially stimulate the ovaries. The crucial point to remember is that the ovulation induction in these ladies must be done by the 'old-fashioned' stimulating injections called HMG (Human menopausal gonadotrophins) which contains both FSH and LH. Recombinant FSH in such women will not be helpful. 

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