Injectable Fertility drugs (gonadotropins)
What are gonadotropins?
Gonadotropins are injectable fertility medications, containing follicle-stimulating hormone (FSH) alone or combined with luteinizing hormone (LH). During a natural menstrual cycle, both FSH and LH are produced by the pituitary gland in the brain to naturally stimulate the ovaries to produce 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).
Gonadotropins are used during fertility treatments such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Injections of gonadotropins are started early in the menstrual cycle to cause multiple eggs to grow to a mature size. Human chorionic gonadotropin (hCG), another injectable medication, is then used to trigger the release of the eggs when they are mature. Close monitoring of patients with ultrasound who are using these medications is advised in order to minimize the side effects and risks.
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When FSH is given in larger amounts than would occur in a natural menstrual cycle it results in more than one egg being ripened and matured.
1. Sometimes if you are not ovulating, Gonadotrophins are given in the amount roughly equal to that of a natural menstrual cycle and this is called ovulation induction.
2. Gonadotrophins are commonly used in IVF cycles. The intention here is to produce ideally 10 to 15 eggs with the aim of fertilizing them outside the body. The reason why so many eggs are necessary is that the process of IVF is relatively inefficient and the more eggs that are available for fertilization, the more likely pregnancy is to
While on Orgalutran IVF, an ultrasonographer will perform ultrasound examinations to check the progress of the follicles. Depending on the response to the fertility therapy, blood tests and ultrasounds may be done on a daily basis. At times you may hear IVF patients comment that they had many immature eggs despite being on Orgalutran medication; some patients relate this to time allocated during ovarian stimulation. They believe if time was extended, the situation (immature eggs) would have been prevented. However, this is not the case since some women are at risk of immature eggs during IVF because of:
In Vitro Fertilisation is a major breakthrough in embryo research and has increased the possibility of large numbers of women becoming pregnant. It is a procedure used to overcome a range of fertility issues caused by damaged or blocked fallopian tubes. This procedure is conducted by a medical physician in a specialized laboratory by removing eggs from the ovaries of a female and mixing it with sperm from the male, fertilize them in a laboratory, and then replace the embryos back into the female’s uterus where they implant and maturation begins. (IVF Australia 2016) The fertilized egg (embryo) is allowed to grow in a protected environment for some days before being
In-vitro fertilisation is a procedure used to overcome a range of fertility issues and helps conceive
Remember, if a woman ovulates regularly on her own, using Letrozole for fertility leads to the development of many follicles and release of multiple eggs, this is known as superovulation or controlled ovarian hyperstimulation. In a natural menstrual cycle, the release of many eggs increases the chance of conception when compared to the release of a single
FSH (Follicle Stimulating Hormone) is produced by the brain via the pituitary gland which stimulates ovarian follicles into maturing eggs. When hyper-stimulation occurs with FSH where the woman will take hormone injections daily for up to 12 days, instead of the woman just ovulating one egg, she will ovulate anywhere between 6 and 12 eggs. The more eggs increase the chance of having a good-quality embryo to transfer.
Gonadotropin is individual group of protein hormones that considered being energetic to human reproduction. Gonadotropins are produced by anterior pituitary. Follicle – stimulating hormone and luteinizing hormone are discussed to together as gonadotropins. They control the purpose of the gonads. In both sexes, Follicle – stimulating hormone (FSH) motivates gamete making, and luteinizing hormone (LH) promotes creating of gonadal hormones. They are the main types of gonadotropin. In Females, luteinizing hormones work with follicle stimulating hormone to produce an egg-containing ovarian follicle to mature. Luteinizing Hormone later separately activates ovulation and helps separation and statement of ovarian hormones. In males, LH arouses the
Anterior pituitary gonadotrophins target the ovaries and testes. Gonadotropes in the anterior pituitary secrete follicle secreting hormone (FSH) stimulating the growth of ovarian follicles and the secretion of estrogen in the ovaries and sperm production in the testes as well as luteinizing hormone (LH) which stimulates ovulation and testosterone. Thyrotropes secrete thyroid stimulating hormone (TSH) to the thyroid glandstimulating thyroid growth and secreting thyroid hormone (TH). Thyroid hormone affects
Hormones released from the anterior pituitary are gonadotropins and it has two FSH and LH. Follicle stimulating hormone (FSH) has to do with the ovaries, stimulates the development of eggs and follicles for females. In males the testes are involved and stimulates production of sperm. Luteinizing hormone (LH) functions to tell the ovaries and testes to make other hormones. For example, in females it stimulates ovulation and secretes estrogen. In males the stimulation of interstitial cells of testes secretes testosterone.
The levels of FSH and LH are important in determining the ovarian-axis problems. If history and physical examination findings are suggestive of hyperandrogenism, androgen testings which include testosterone, dehydroepiandrosterone (DHEAS), androstenedione, and 17-OH progesterone to determine the organ of cause (e.g.: adrenal gland or ovary) are helpful. History and examination suggestive of hyperprolactinaemia or thyroid disorders require evaluation of the levels of prolactin and thyroid function.
The process of embryo transfer requires a dose of Follicle Stimulating Hormone (FSH) twice a day for four days towards the end of her estrus cycle to force them to super ovulate, or release more than one egg at a time. On average a donor cow will release five to six eggs at a time but other donors will release more than twenty. Once the donor cow comes into heat, the peak time for insemination to occur, a technician will artificially inseminate the cow with high quality semen multiple times due the increased number of eggs being released by the donor cow. After seven days the embryos will be flushed out and graded. (Embryo) The other method, In Vitro Fertilization, does not fertilize eggs inside of the donor cow, they are flushed out unfertilized and placed into petri dishes, where they are matured for 24 hours before insemination. Eggs are mixed with semen and then incubated for seven days, after which they are considered embryos and are ready for transfer to the recipient cow. (In
Subdermal implant (Implanon): etonogestrel (a synthetic progestin). ENG [13-Ethyl-17-hydroxy-11-methylene-18,19-dinor-17α-pregn-4-en-20-yn-3-one. Normal menstrual cycle: lasts about 28 days. Is controlled by the cyclic release of Follicle Stimulating Hormone (FSH) from the pituitary gland. When the FSH level spikes, theca cells produce testosterone, which diffuses into the follicles (egg containing sacs) where it is transformed into estrogen. This results in the development of the egg inside the ovary. When the LH (Luteinizing Hormone) level spikes, the ovary is stimulated to release the most mature egg. Prior to ovulation, estrogen levels rise and FSH levels fall, which signals LH to
The eggs are then extracted after approximately one-two months of medication. Afterwards, the eggs and the sperm from the husband are then allowed to fertilize to create embryos – preferably without assistance – in a medical laboratory for three to five days before being placed back into the uterus of the wife. The quality of the eggs will determine how long they are left to fertilize; however, the longer they are able to fertilize, the better the chances of a pregnancy. Once the embryos are placed back into the woman’s uterus, it will be up to her body to either accept or reject the embryos and become pregnant.
Controlled ovarian hyperstimulation (COH) is known to be an important component in the success of in vitro fertilization–embryo transfer (IVF-ET). In COH procedure, in order to suppress and prevent premature luteinizing hormone (LH) surge, GnRH agonists and antagonists are often applied.
IVF involves a total of 3 steps: oocyte retrieval from the egg donor which is stimulated by recombinant FSH
Oocyte developmental competence has been reviewed abundantly in the scientific literature (Sirard MA et al 2006; Hussein et al 2006; Moussa et al 2015; Labrecque and Sirard 2014). All of them agree that an oocyte with low developmental competence has very small chances to produce an embryo using standard IVF. Oocyte developmental competence has been correlated to various biological and physiological factors such as follicle size, degree of follicle atresia, presence or absence of key follicular molecules, to name a few. Current commercial businesses use IVF systems that can permit a developmentally competent oocyte to be fertilized and produce an embryo. These same systems are not capable to induce or convey the necessary molecular signals or molecules to oocytes to acquire developmental competence during in vitro maturation. Therefore, it is up to experts performing OPUs to use the best strategies to prepare donors to produce developmentally competent oocytes for IVF. Commercially, synchronization and superovulation are the most used approaches to attain this goal. But it is possible to produce IVF embryos following OPU of donors that have not been superovulated. Therefore, there is a trade off. Use existing drugs to synchronize and superovulate a donor to increase the number of developmentally competent oocytes and thus result in a