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Human Reproduction, Vol. 14, No. 6, 1411-1417, June 1999
© 1999 European Society of Human Reproduction and Embryology

Debate

Clinical efficacy of recombinant gonadotrophins

Adam H. Balen1, Catherine J. Hayden and Anthony J. Rutherford

Department of Reproductive Medicine, Clarendon Wing, Leeds General Infirmary, Leeds LS2 9NS, UK

The advent of recombinantly-derived gonadotrophin preparations has been heralded as a major breakthrough in the therapeutic armory of assisted reproduction treatments (McDonough, 1995Go). Godwin Meniru poses a timely question by asking whether the new generation of drugs is providing any real benefit (Meniru, 1999Go). To date there are two recombinant follicle stimulating hormone (rFSH) preparations: follitropin {alpha} (Gonal-F; Serono Laboratories) and follitropin ß (Puregon, Organon Laboratories). In discussing the benefits of a gonadotrophin preparation, one has to consider clinical efficacy, side-effects and cost-effectiveness. Clinical efficacy includes the ability to stimulate folliculogenesis, the production of mature oocytes, appropriate steroidogenesis for endometrial development and, in the context of in-vitro fertilization (IVF), sufficient quality pre-embryos and, ultimately, good pregnancy rates. Before moving on to these fundamental issues, we would like first to discuss the particular points raised by the first paper in this debate (Meniru, 1999Go).

Meniru (1999) cites another paper . . . [Full Text of this Article]

Historical perspective

Advantages and disadvantages of rFSH

Assessment of clinical practice using recombinant human gonadotrophins for ovulation stimulation and ovulation induction

IVF
Ovulation induction
Future prospects

Conclusion – do we need gonadotrophins?

Ovulation induction for hypogonadotrophic hypogonadism
Ovulation induction for polycystic ovary syndrome
Ovulation stimulation for assisted conception
Notes

References


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