Rigi10™ Malleable Penile Prosthesis
Also Known As
FSH (Follicle-Stimulating Hormone), LH (Luteinizing Hormone), hCG (Human Chorionic Gonadotropin), Gonadotrophins, Gn, Follitropin, Lutropin, Choriogonadotropin
Definition
Gonadotropins are peptide hormones that regulate ovarian and testicular function and are essential for normal growth, sexual development, and reproduction.1 These glycoprotein hormones are secreted by gonadotropic cells of the anterior pituitary of vertebrates.2 The human gonadotropins include follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which are made in the pituitary, and human chorionic gonadotropin (hCG) which is made by the placenta.3
All three gonadotropins are heterodimeric proteins consisting of two peptide chains: an alpha chain that is similar in all three, and a beta chain that is unique and determines the specific receptor interactions and function of each hormone.4 The pituitary gonadotropins (FSH and LH) are under the control of gonadotropin-releasing hormone (GnRH), a decapeptide produced in the hypothalamus and released in response to circulating levels of estrogens and progesterone.5
The gonadotropins act on the gonads (testes in males and ovaries in females), controlling gamete production and sex hormone synthesis.6 In females, FSH stimulates the development of ovarian follicles and LH triggers ovulation and promotes the corpus luteum to produce progesterone. In males, FSH promotes spermatogenesis while LH stimulates the production of testosterone by the testes.7 These hormones are central to the complex endocrine system that regulates normal growth, sexual development, and reproductive function.8
Clinical Context
Gonadotropins play a crucial role in reproductive medicine and are used clinically in various contexts.1 Highly purified and recombinant formulations of gonadotropins have been developed and used in the treatment of hypogonadism and infertility.2 These therapeutic applications include:
In female patients, gonadotropins are primarily used to treat infertility through ovulation induction and as part of assisted reproductive techniques (ART) such as in vitro fertilization (IVF).3 FSH preparations stimulate follicular development, while hCG is used to trigger ovulation by mimicking the natural LH surge. Clinical trials have shown that hCG treatment resulted in pregnancies in approximately 30% of women with ovulatory dysfunction.4
In male patients, gonadotropins are used to treat hypogonadism, stimulate testosterone production, and improve spermatogenesis in cases of male infertility.5 FSH promotes sperm production while LH or hCG stimulates testosterone synthesis by the Leydig cells in the testes.
Gonadotropin deficiency due to pituitary disease results in hypogonadism, which can lead to infertility.6 Treatment includes administered gonadotropins, which work as fertility medication. Such preparations can either be produced by extraction and purification from urine (menotropins, also called human menopausal gonadotropins) or be produced by recombinant DNA technology.7
Patient selection for gonadotropin therapy requires careful consideration, as these hormones can cause side effects, particularly in women. The most significant adverse event is ovarian hyperstimulation syndrome (OHSS), which can occur in 1-10% of treated women.8 Severe forms of OHSS can be accompanied by serum enzyme elevations, jaundice, and even ascites. This syndrome typically arises within 4 to 14 days of ovarian stimulation with gonadotropins and is characterized by abdominal pain, distension, ascites, and enlarged ovaries with cysts.5
The dosage and administration regimens of gonadotropins vary by indication and should be managed only by healthcare providers with expertise in reproductive endocrinology and infertility treatment.4