Oestrogen helps restore fertility

Women who want to conceive, but who have stopped ovulating before reaching the age of menopause (due to premature ovarian failure), have a better chance of ovulation when given pretreatment with oestrogen before stimulation of the ovaries. Earlier results of treatment to induce ovulation in women with premature ovarian failure have been poor. Researchers from the Universita di Bari, Italy, explored the hypothesis that treatment with oestrogen before ovarian stimulation could improve the response of the ovarian follicles. Among 25 women pretreated with oestrogen, 9 developed a follicle at least 18 mm in diameter before human chorionic gonadotropin was administered to stimulate ovulation. Eight of these patients ovulated. In contrast, only 3 of the 25 women who were not pretreated with oestrogen (the control group) showed scant follicular growth during ovarian stimulation and none of them ovulated. Four of the 8 oestrogen-pretreated women who ovulated were able to conceive, and all 4 delivered at the end of pregnancy. Twenty women who were in the control group were then pretreated with oestrogen, and 4 ovulated. Overall, nearly one third of the 37 patients who had not ovulated for more than 6 months did manage to ovulate when pretreated with oestrogen. The researchers suggest that women with premature ovarian failure, should undergo ovulation induction after oestrogen pre-treatment, before they're referred to an egg donor programme.