Ovulation, induction

Commercialized for different indications breast cancer treatment, contraception, ovulation induction, prevention and treatment of postmenopausal osteoporosis. 

Artini, P. et al. (1996). Growth hormone co-treatment with gonadotrophins in ovulation induction. J. Endocrinol. Invest. 19(11), 763-779. 

The indications for the use of gonadotropins are for boys and men respectively undescended testes and secondary hypogonadism. For women gonadotropins are used for ovulation induction. 

Nugent D, Vandekerckhove P, Hughes E, Arnot M, Lilford R. Gonadotrophin therapy for ovulation induction in subfertility associated with polycystic ovary syndrome. Cochrane Database Syst Rev 2000. 

Santbrink EJPV, Fauser BCJM. Is there a future for ovulation induction in the current era of assisted reproduction. Hum Reprod 2003 18(3) 2499-502. 

Ovarian enlargement is the most common side effect of clomiphene use. The occurrence of multiple births following ovulation induction with clomiphene is 4 to 9% 90% of these multiple births are twins. Since clomiphene is teratogenic, therapy should be discontinued if there is a chance that conception has occurred. Rarely, irreversible ocular toxicities have been reported with clomiphene use. 

Uniabeied Uses Treatment of mastalgia, gynecomastia, pancreatic carcinoma, ovulation induction... 

Induction of ovulation, induction of spermatogenesis in men GI 120552 FoIIitropin-beta precursor (follicle-stimulating hormone-beta) (FSH-beta) PID gl20552 Human follicle stimulating hormone PDB ID IFL7... 

In women treated with gonadotropins and hCG, the two most serious complications are the ovarian hyperstimulation syndrome and multiple pregnancies. Overstimulation of the ovary during ovulation induction often leads to... 

Suspicions that clomiphene might adversely affect a fetus that has developed as a result of successful ovulation induction are difficult to confirm or allay, since the condition for which clomiphene is being used, that is subfertility, might itself be associated with a risk of malformation. The fear originally arose after 18 cases of trisomy had been reported... 

Vollenhoven BJ, Healy DL. Short- and long-term effects of ovulation induction. Endocrinol Metab Clin North Am 1998 27(4) 903-14. 

Cornel MC, ten Kate LP, Dukes MN, de Jong-v D, Berg LT, Meyboom RH, Garbis H, Peters PW. Ovulation induction and neural tube defects. Lancet 1989 1(8651) 1386. 

Szilagyi A, Bartfai G, Manfai A, Koloszar S, Pal A, Szabo I. Low-dose ovulation induction with urinary gonadotropins or recombinant follicle stimulating hormone in patients with polycystic ovary syndrome. Gynecol Endocrinol 2004 18 17-22. 

Van Wely M, Andersen CY, Bayram N, Van Der Veen F. Urofollitropin and ovulation induction. Treatm Endocrin 2005 4 155-65. 

Follitropin treatment for infertility has been reviewed in detail (1,2). Multiple pregnancy occurs in 20% of patients, 80% being twin pregnancies. There is no documented increase in congenital abnormalities in children conceived after ovulation induction with follitropin. 

A 32-year-old woman who was not obese developed benign intracranial hypertension in association with ovarian hyperstimulation syndrome after ovulation induction using goserelin, follitropin, and human chorionic gonadotropin (hCG) (3). The syndrome did not recur during a second pregnancy in which follitropin and hCG were not used... 

A previously healthy 34-year-old woman who underwent ovulation induction with leuprorelin acetate and FSH developed abdominal ascites due to OHSS, followed by acute aphasia and right hemiparesis (76). The stroke was caused by a large intracardiac thrombus. 

A review identified 54 other reports of thromboembolic disease associated with ovulation induction 60% were in upper limb veins and two-thirds of the patients had OHSS (77). The mechanism for the increased risk of thrombosis in these patients has not been determined, but hemoconcentration or a hypercoagulable state associated with high estrogen concentrations could be responsible. 

Figure 11.5 Ovulation induction by leuprorelin in diestrous rats after iv, sc, rectal, nasal, oral, and vaginal routes of administration. (Note nasal absorption may have been underestimated in this study, due to drainage of the test solution. For example, nasal bioavailability has been determined as 18.7% in rats, in a study in which the nasal cavity was closed at the orifice and outlet)...

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