Induction of ovulation with human menopausal gonadotropin; with special reference to ovarian hyperstimulation syndrome and hormone excretion.

HMG-hCG therapy was performed on 109 patients who had previously received various forms of treatment but had failed to ovulate or become pregnant. From among the 109 patients, 80 (73.4%) succeeded in ovulation and 37 (33.9%) became pregnant. Ten patients with high FSH and low estrogen levels before the therapy failed to ovulate and were believed to have amenorrhea of ovarian origin. This indicated the importance of measurements of gonadotropin and estrogen prior to therapy with exclusion of patients in whom hMG-hCG therapy is expected not to be effective. Signs of ovarian hyperstimulation syndrome, such as ovarian enlargement, ascites and hydrothorax, were seen in 58% of 245 treated cycles. Our study revealed that there was remarkable increase in the levels of estrogen and progesterone in the majority of patients who presented clinical signs of ovarian hyperstimulation. indicating superovulation as the main cause of ovarian hyperstimulation syndrome which was confirmed at operation.