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"Exogenous Gonadotropins:
Gonadotropins are used to treat infertility in anovulatory women, usually after other less complicated and costly methods have failed. They are also used to help women with Hypogonadotropic amenorrhea (HA) to treat infertility as there is inadequate amounts of endogenous circulating follicle stimulating hormone (FSH) and luteinizing hormone (LH) in such patients.
Additionally, gonadotropins are used to induce development of multiple follicles for fertility treatments, such as superovulation- intrauterine insemination (IUI) and in vitro fertilization (IVF).
How it acts !
Exogenous FSH stimulates proliferation of granulosa cells and follicular growth. LH stimulates the production of androgen in thecal cells that subsequently is converted to estrogen by granulosa cells via aromatization. The goal of treatment is to promote the growth and development of a single mature follicle.Gonadotropin therapy has significant risks and is costly, it should therefore be used only by clinicians having the requisite training and experience.
Indications !
Exogenous gonadotropins can be used for ovulation induction (OI) in women who are anovulatory and infertile, and they are indicated when OI cannot be achieved with less complex methods. Two groups of anovulatory disorders may require gonadotropin therapy:
Hypogonadotropic Amenorrhea (HA, also known as hypogonadotropic hypogonadism, hypothalamic amenorrhea, or World Health Organization [WHO] type I amenorrhea); and
Polycystic Ovary Syndrome (PCOS, also known as hyperandrogenic amenorrhea or WHO type II amenorrhea)
In women with HA, optimal clinical results are achieved by the combined administration of FSH and LH , accomplished by administration of hMG or a combination of FSH and either recombinant LH or low-dose hCG. There are no established gonadotropin regimens for OI of HA patients and no prospective studies that assess treatment outcomes with different gonadotropin dosages..."
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