CURTAIN RAISER 8 – Gonadotrophin in Assisted Reproductive Technology (ART)

This video will give an in-depth overview of understanding the Role of Gonadotrophins in Infertility and ART

Follicle Stimulating Hormone (FSH)

Essential for follicle growth and maturation

Regulates the production of Estradiol in women and sperm production in men

Luteinizing Hormone (LH)

Triggers ovulation in women

Supports testosterone production in men

Estradiol

Key hormone for female reproductive health

Regulates menstrual cycle and supports embryo implantation

Serum Progesterone

Supports the endometrium to allow embryo implantation

Indicates the presence of a functional corpus luteum

Assessing Ovarian Reserve and Hormonal Therapy Options

Ovarian Reserve

Evaluates a woman’s reproductive potential

Involves assessing the number of available eggs and their quality

Clomiphene and Letrozole

Oral medications used to stimulate ovulation

Induce the release of gonadotrophins (FSH and LH) from the pituitary gland

Gonadotrophin Therapy

a.Injection-based hormonal treatment

It involves injecting synthetic hormones into a woman’s body to stimulate the ovaries to produce eggs. These hormones mimic the action of the natural hormones produced by the pituitary gland in the brain that regulate the menstrual cycle.

b.Directly stimulates the ovaries

The hormones in the injections stimulate the follicles in the ovaries to grow and mature. Follicles are fluid-filled sacs that contain immature eggs. The therapy aims to stimulate the ovaries to produce multiple mature follicles.

c.Produce multiple mature follicles

The goal of gonadotrophin therapy is to produce multiple mature follicles that can be fertilized by sperm. This increases the chances of pregnancy for women who are having difficulty conceiving. The maturation of multiple follicles is monitored through ultrasound scans and blood tests, and the timing of ovulation is determined to optimize the chances of fertilization.

Types of Gonadotrophins Used in ART

Human Menopausal Gonadotrophins (HMG)

Obtained from the urine of postmenopausal women

Contains a mix of FSH and LH

Human Chorionic Gonadotrophin (HCG)

Mimics the action of LH

Used to trigger ovulation in ART

Recombinant Gonadotrophins

Produced using recombinant DNA technology

Offers greater purity and consistency

Commonly Used Recombinant Gonadotrophins

Gonal-f (Recombinant FSH)

Used to stimulate follicle development in women

Can also be used for male fertility treatment

Recagon (Recombinant FSH)

Similar to Gonal-f in function

Another option for follicle stimulation in women

Follisurge (Recombinant LH)

Supports follicle maturation and ovulation

Often used in combination with recombinant FSH

Folligraph (Recombinant HCG)

Triggers final oocyte maturation and ovulation

Used in ART procedures like in vitro fertilization (IVF) and intrauterine insemination (IUI)

Urinary Gonadotrophins

Alternative to recombinant gonadotrophins

Derived from human urine

May contain varying levels of FSH, LH, and HCG