Gonadotropins (LH, FSH) are produced naturally by the pituitary gland to stimulate ovulation in women. The injectable form of gonadotropins has been used since the late 1960s to treat women with ovulation difficulties. Today’s gonadotropins are either produced in the laboratory (recombinant technology) or as a highly purified extract of urine. Treatment usually consists of seven to ten days of daily injections with short, thin needles (subcutaneous route). This treatment is closely monitored with frequent ultrasounds and blood estrogen levels. Approximately 90 percent of patients who do not normally ovulate will ovulate while on injectables. Conception rates vary but are approximately 15 to 25 percent per cycle.

Indications:
Infertile Patients who do not respond to oral ovulation-induction medications or patients undergoing in-vitro fertilization treatment are candidates for gonadotropin use.

Contraindications and adverse effects:
Injectable gonadotropins are very expensive and treatment may result in multiple births (including higher-order multiples such as triplets and quadruplets) or hyperstimulation syndrome. The latter is an uncommon complication that may involve abdominal pain and swelling, nausea and vomiting, and weight gain. This condition may be life threatening if not monitored. Multiple births occur in 20 percent of all pregnancies on injectable gonadotropins. Most of these are twins. These medications should not be used in patients with chronic debilitating conditions involving heart, lung, or kidney compromise.