Evolution of clinical agents for ovulation induction

Article Abstract:

New developments may improve gonadotropin therapy for ovulation induction (OI). The number of agents used for OI has been fairly stable until recently. Nongonadotropin therapies for OI may replace gonadotropin therapy by the end of the 1990s. Highly purified follicle-stimulating hormone (FSH) may be a new gonadotropin preparation for OI which may be more effective than urofollitropin. Recombinant technologies may enable standard amounts of protein to be administered rather than international units of medications which measure bioactivity. Very pure drugs may be administered subcutaneously rather than intramuscularly, which may make self-administration easier and more comfortable for patients. Genetically engineered human gonadotropins may include recombinant luteinizing hormone and human chorionic gonadotropin and chimeric FSH. Nongonadotropin agents may include receptor analogues, cytokines, growth factors, binding proteins, and narrow-action oligopeptides. Gene therapy may enable locally active components of growth factors to be delivered to the ovary to regulate OI.

Care and treatment, Growth factors, Cytokines, Infertility, Female, Female infertility, Follicle-stimulating hormone, Urofollitropin

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Adjunctive agents in ovulation induction

Article Abstract:

Adjunctive medications may be used in ovulation induction regimens for women with ovulatory dysfunction who are poor responders to OI. Adjunctive agents may be used when standard ovulation medications do not produce enough follicles or when an unwanted response such as premature luteinization or hyperstimulation occurs. Human growth hormone and growth hormone-releasing hormone may be used for patients who respond poorly to high doses of gonadotropins. They may not be useful in the most common group of poor responders, women over 40 with follicular phase defects. Clomiphene citrate may be used in increasing doses if spontaneous ovulation therapy results in failure to ovulate. Gonadotropin releasing hormone analogs may be useful in conjunction with assisted reproductive technology in the setting of superovulation. Bromocriptine may not be effective in inducing ovulation in women with normal prolactin levels. Inhibins and activins may have no use as primary medications or as adjunctive therapy for OI.

Drug therapy, Corticosteroids, Adrenocortical hormones, Panel Discussion, Somatotropin, Gonadotropin releasing hormone, Gonadorelin, Infertility

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