Hypogonadotropic Hypogonadism: Can have Multiple Pregnancy and or Ovarian Hyper Stimulation Syndrome

Hypogonadotropic hypogonadism (HH) is the least common etiology of all the causes of infertility. Patients in whom fertility is desired, induction of gonadotropin secretion by pulsatile GnRH or treatment with exogenous gonadotropin is the current treatment of choice. Ovulation induction in patients with hypogonadotropic hypogonadism (HH) is a challenge to the treating physician. The ovarian response in HH cannot be predicted and may differ substantially from that of normal patients. A step-up protocol longer duration of stimulation is required in some cases to reach that threshold levels of follicle stimulating hormone, in so as to prevent multiple pregnancies and to eliminate the risk of ovarian hyper stimulation syndrome (OHSS).