image by: HWN

HWN Suggests

Are Injectable Fertility Drugs Safe?

I have all too often heard it said that medical providers knowingly place unsuspecting infertile women at risk of developing cancer through the fertility injectable drugs and treatment they administer and that we knowingly place patients at risk by understating medical risks associated with the use of fertility treatments. To me this is both offensive and untrue. It is true that the indiscriminate use of gonadotropin therapy to stimulate follicle and egg development is not without risk. However the assertion that gonadotropin stimulation increases the risk of cancer is in my opinion baseless. To illustrate my point, let us together trace how that the use of gonadotropin fertility agents...

read full article

Featured

 Gonadotropin stimulation: past, present and future

Gonadotropin therapy is so central to infertility treatment that it is easy to overlook the considerable discovery and research that preceded production of the effective and safe products available today. The history underpinning this development spans over 300 years and provides a splendid example of how basic animal experimentation and technological advances have progressed to clinical application. Following the discovery of germ cells in 1677 and realizing, in 1870, that fertilization involved the merging of two cell nuclei, one from the egg and one from sperm, it took another 40 years to discover the interplay between hypothalamus, pituitary and gonads. The potential roles of gonadotropin regulation were discovered in 1927.

Articles of Interest

Significance of Gonadotropins in Treating Infertility

Over the last century, efforts have been made to improve gonadotropin preparations. Current gonadotropins have unquestionably higher quality and safety profiles, as well as clinical efficacy, than previous generations. The use of recombinant technology in the production of Follicle-Stimulating Hormone, Luteinizing Hormone, and Human Chorionic Gonadotropin (hCG) has been a significant accomplishment. Recombinant gonadotropins are purer than urine-derived gonadotropins, and using mass filling in vials virtually eliminated batch-to-batch variations and allowed for precise dosing.

Fertility drug: Gonadotropins

Repronex, Menopur: Human menopausal gonadotropin (hMG), a mixture of luteinizing hormone (LH) and follicle stimulating hormone (FSH). Follistim, Gonal-F, Bravelle: Urofollitropin or recombinant FSH, pure FSH. Pregnyl, Novarel, Ovidrel: Human chorionic gonadotropin (hCG), a "recombinant" hCG drug, engineered differently from the others.

Gonadotropin Stimulation

Repronex (HMG), Bravelle, Follistim, Gonal F, Follistim AQ Pen, and Gonal-F RFF Pen (FSH) are injectable hormones which are chemically identical to the natural pituitary hormones that control ovulation and may be produced by synthesis or extraction from the urine of postmenopausal women. These natural hormones are used clinically for the stimulation of follicle and egg development in the ovary. Their use is not associated with evidence of teratogenicity (abnormal development in the baby). A further advantage of these drugs is that they do not require normal hormone production by the hypothalamus or pituitary for their action. Therefore, they can be used in a patient with underactive pituitary production of the hormones that normally stimulate ovarian or testicular function.

Gonadotropin therapy in assisted reproduction: an evolutionary perspective from biologics to biotech

Gonadotropin therapy plays an integral role in ovarian stimulation for infertility treatments. Efforts have been made over the last century to improve gonadotropin preparations. Undoubtedly, current gonadotropins have better quality and safety profiles as well as clinical efficacy than earlier ones. A major achievement has been introducing recombinant technology in the manufacturing processes for follicle-stimulating hormone, luteinizing hormone, and human chorionic gonadotropin. Recombinant gonadotropins are purer than urine-derived gonadotropins, and incorporating vial filling by mass virtually eliminated batch-to-batch variations and enabled accurate dosing.

Gonadotropin therapy: a 20th century relic

Gonadotropin therapy has been a cornerstone of infertility therapy for half a century. From the very beginning, its use has been associated with a high rate of multiple births, particularly high order multiples, and ovarian hyperstimulation syndrome. Initially, success rates seemed acceptable when used for superovulation (SO)/IUI therapy. However, as data from RCTs have emerged, reported outcomes suggest that we question the use of injectible gonadotropins.

Less is more ‥‥ Increased gonadotropin use for ovarian stimulation adversely influences clinical pregnancy and live birth following IVF

Our data add to the accruing literature suggesting adverse influences of excess gonadotropin use on IVF outcomes. While an aggressive approach to COH results in significant reduction in CC, excessive use of gonadotropins detrimentally influences the eventual outcome of interest i.e. live birth following IVF.

Ovulation Induction With Gonadotropins

Ovulation induction with gonadotropins has become a standard part of the armamentaria of physicians treating women with ovulatory dysfunction. The treatment has been used effectively for more than 50 years. Urinary preparations of gonadotropins are being superseded by recombinant technology; this increases the consistency of the medication, possibly will improve outcomes, and, one hopes, decrease the cost. As a result, we can continue to view ovulation induction as a major and ever-improving component in the treatment of infertility.

Side effects of injectable fertility drugs (gonadotropins)

Gonadotropins are fertility medications given by injection that contain follicle-stimulating hormone (FSH) alone or combined with luteinizing hormone (LH). During a regularly occurring menstrual cycle, both FSH and LH are produced by the pituitary gland in the brain to naturally stimulate the ovaries to make a single egg each month. When FSH (with or without LH) is given as an injection, it works directly on the ovaries to make multiple follicles (cysts containing eggs), which helps to promote fertility. Other fertility medications, such as clomiphene citrate, stimulate the ovaries by working in conjunction with the brain.

Unlocking Fertility Potential: A Comprehensive Guide To Gonadotropin Therapy

Gonadotropin therapy is commonly employed in assisted reproductive technologies, such as in vitro fertilization (IVF) and intrauterine insemination (IUI). It is recommended for individuals with conditions like polycystic ovary syndrome (PCOS), unexplained infertility, or those who do not respond adequately to other fertility treatments.

Resources

5 Hormone Treatments for Infertility

For couples struggling to conceive, hormonal therapy can be a life-changing solution as many cases of infertility can be attributed to hormonal imbalances. Hormone treatments work by controlled ovarian hyperstimulation to promote egg maturation and ovulation.