Gonadotropin therapy: a 20th century relic
A historical review of gonadotropin therapy is presented with a summary of studies that have examined its use for anovulation, superovulation, and IVF. A view of a future that nearly eliminates its use is proposed.
Richard H. Reindollar, M.D. and Marlene B. Goldman, Sc.D.
Volume 97, Issue 4 , Pages 813-818, April 2012
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. This manuscript examines the studies that have challenged gonadotropin use for SO/IUI and other research that supports reduced doses of gonadotropins for IVF. We examine the challenges for its continued use for SO/IUI and for moving to lower doses worldwide for IVF. We propose a future that views gonadotropins as a relic of the twentieth century.