GnRH stimulation test in female patients with FHA

Aims: Functional hypothalamic amenorrhea (FHA) is a common cause of secondary amenorrhea. Nearly 50% of FHA-women reveal polycystic ovarian morphology (PCOM), a known risk factor for ovarian hyperstimulation syndrome (OHSS). However, when undergoing IVF, gonadotropin releasing hormone-agonist (GnRH-a) triggers are currently not recommended for FHA patients, since an inadequate endogenous surge in luteinizing hormone (LH) is expected. We aimed to challenge this concept and evaluated LH levels after GnRH stimulation in women with FHA with and without PCOM. Materials and Methods: In a retrospective cohort study, 82 women with FHA, who underwent a GnRH stimulation test (1mg intravenous gonadorelin), were included. Stimulated LH level was the main outcome parameter.