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pubmed:otherAbstract |
PIP: The 5 general types of hormonal treatment of female and male sterility reviewed here are gonadotropins, gonatoropin-releasing hormone, clomiphine, cyclophenil, and epimestrol. One must 1st diagnose whether a woman is sterile at the ovarian, hypothalamic, or pituitary level, whether she is amenorrheic, menstruating and ovulating or not. Usually human menopausal gonadotropin (HMG) is given for 12 days, then human chorionic gonadotropin (HCG) to incude ovulation. Doses must be regulated to achieve a ratio of luteinizing hormone/follicle stimulating hormone (LH/FSH) of less than 1 in the beginning of the cycle, up to 2 at ovulation, or results can be assessed clinically by vaginal smear, cervical mucus, and ovarian size. Usually pregnancy occurs within 1-3 months, but seldom after 6 months of treatment. LH-releasing hormone (RH) has been used since 1970 after a course of HMG, with variable results. Estrogens are effective in some anovulatory women. Clomiphine is the most effective fertility drug: 50-150 mg is given for 3-5 days, followed by HCG. Cyclofenil, 3-methoxy-17-epi-estriol, and Sexovid are slightly less effective, but produce fewer side effects and cases of hyperstimulation than clomiphine. Methods used for men include gonadotr opins, clomiphine and LH-RH, with variable results depending on the caus e of their infertility.
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