Ovarian Hyperstimulation during Chronic Pulsatile GnRH Therapy

Ovulation Induction with Gonadotropin-Releasing Hormone (GnRH)

“…Large IV dosages of GnRH have resulted in instances of multiple follicular development; however, in each case these regressed without incident after GnRH therapy ceased. 76,83 The incidence of multiple pregnancy associated with GnRH therapy is approximately 7%, 31 with most of these being twins and an occasional set of triplets. 84 Mason and co-workers 85 have suggested that the use of hCG to trigger ovulation may increase the risk of multiple pregnancy by stimulating smaller follicles to ovulate secondarily Since ovulation during GnRH therapy does not require exogenous hCG, they caution that this practice should be avoided to minimize the risk of multiple pregnancy.…”

Monitoring Ovulation Induction: Use of Biochemical and Biophysical Parameters

“…49,50 Unfortunately, further experience with this technique has shown this concept to be only partially true. Mild forms of ovarian hyperstimulation have been reported by many authors in a variety of applications, [51][52][53] and multiple pregnancies (including triplets 54 and quadruplets 55 ) have occurred. Certainly, these complications are infrequent, and they tend to occur only when higher doses of GnRH are employed or when hCG is used to induce ovulation.…”