Estrogen pretreatment can help restore fertility

NEW YORK, May 4 (Reuters) In women who stop ovulating before reaching the age menopause would normally begin, a condition referred to as ''premature ovarian failure,'' who want to become pregnant, pretreatment with estrogen before stimulation of the ovaries improves the likelihood of ovulation, according to a report in the journal Fertility and Sterility.

The results of treatment to induce ovulation in women with premature ovarian failure have been poor, explain Dr Massimo Tartagni and colleagues from Universita di Bari, Italy. The researchers explored the hypothesis that treatment with estrogen before ovarian stimulation could improve the response of the ovarian follicles.

Among 25 women pretreated with estrogen, 9 developed a follicle at least 18 mm in diameter before human chorionic gonadotropin was administered to stimulate ovulation, the researchers report. Eight of these patients ovulated.

In contrast, only 3 of the 25 women who were not pretreated with estrogen (the control group) showed scant follicular growth during ovarian stimulation and none of them ovulated.

Four of the 8 estrogen-pretreated women who ovulated were able to conceive, the researchers note, and all 4 delivered at the end of pregnancy.

Twenty women who were in the control group were then pretreated with estrogen, and 4 ovulated. Therefore, the overall ovulation rate was 32.4 per cent among 37 patients who had not ovulated for more than 6 months.

The researcher suggest that for women with premature ovarian failure, ovulation induction after estrogen pretreatment should be attempted before they're referred to an egg donor programme.

REUTERS AM PM0842