To the Editor.
—Allan R. Glass, MD, made several excellent points in his letter in the March issue of the Archives1 comparing the merits of pulsatile gonadotropin-releasing hormone (Gn RH) therapy with conventional gonadotropin therapy. We agree that the expense of pulsatile Gn RH therapy has been a disappointment, thus far. In our institutions, the cost of Gn RH therapy has been comparable to gonadotropin therapy. The infusion pumps are rented to the patients by the hospital for $200 per therapeutic course, so that the total cost can be amortized over many cycles. Although we are currently intensively monitoring these patients, this will probably not be necessary in the future.Pulsatile Gn RH administered to outpatients is well tolerated, and, in women, spontaneous ovulation with a single follicle occurs consistently enough that the scrutiny required for gonadotropin therapy may be avoided. These factors may ultimately result in less expensive