Stimulating Hormone (FSH)
are many fertility drugs available for the treatment of female infertility.
One class of fertility drugs is known as ovulation induction agents.
Clomid is a member of
this class and is discussed on a separate page. The other fertility
drugs in this class are the gonadotropins and include Gonal-F, Follistim,
Bravelle, Repronex and others.
hormones are produced by the pituitary gland and include follicle
stimulating (FSH) and luteinzing hormones (LH). The pituitary gland
is influenced by gonadotropin releasing hormone (GnRH) which is
excreted by the hypothalamus. The hypothalamus is part of a biofeedback
mechanism know as the hypothalamic, pituitary, adrenal axis. The
hypothalamus "measures" levels of various hormones, such
as estrogen, and stimulates the production of FSH by the pituitary
was the first gonadotropin fertility drug marketed for ovulation
induction and it was derived from the urine of post menopausal women.
FSH levels rise dramatically after menopause and it is excreted
in the urine. Pergonal is not "pure" FSH because it has
equal amounts of FSH and LH.
pure FSH products, such as Gonal-F and Follistim, are produced by
genetic recombinant technologies and are identical to human FSH.
stimulates the ovaries directly causing the recruitment and development
of many eggs. They are administered by injection and directly stimulate
the development of eggs within the ovarian follicles. FSH is used
in virtually all ART cycles because additional eggs are needed for
the manipulation processes.
can cause side effects and patients must be closely monitored by
a reproductive endocrinologist. Dosages are adjusted based upon
each patient's individual response to avoid conditions such as ovarian
hyperstimulation syndrome (See the Serono Web site for more information
on this condition.)
Lupron, Antagon, Cetrotide
hypothalamus releases gonadotropin releasing hormone (GrRH) which
stimulates the pituitary to produce FSH. FSH then stimulates egg
recruitment and development within the ovarian follicles. Fertility
durgs in this category block the effects of GnRH albeit by different
mechanisms. When GnRH is blocked the pituitary cannot produce significant
amounts of FSH and LH thus follicular development and ovulation
are "blocked". This condition is termed "down regulation".
patients usually receive either Lupron or Antagon/Cetrotide based
upon their treatment plan. Once the patient is down regulated, FSH
is administered to stimulate follicular development and continued
until the eggs mature. These patients cannot ovulate until an injection
of hCG is given, therefore, the IVF team can precisely monitor/time
completely blocks the effects of GnRH meaning fewer injections are
necessary. However, more FSH may be required to stimulate adequate
ABOUT DEPOT LUPRON
Chorionic Gonadotropin (hCG)
first hCG fertility drug, Profasi and Pregnyl, were derived from
chorionic cells found within the placental tissue. During a normal
ovulatory cycle, the pituitary releases a burst of LH, which stimulates
ovulation (egg release). Most women undergoing ovulation induction
are down regulated by medications such as Lupron or Antagon. These
products block the pituitary's production of LH and ovulation can
not occur until the drug is discontinued or an external source of
LH is added.
can be triggered by an injection of hCG because the body does not
differentiate between LH and hCG. Once hCG is given the IVF retrieval,
I or insemination (if it is an IUI cycle), is scheduled 36 hours later.
This timing mimics the body's natural cycle.
Laboratories launched Ovidrel, which is a pure hCG product and Luveris,
which is pure LH. Both of these products are derived from genetic
recombinant technology. Luveris allows physicians to precisely titrate
the dosages of FSH and LH.