Pharmacological ovarian stimulation has a major role in reproductive medicine and has been used in anovulatory patients and in the induction of multifollicular development required for the procedures of assisted reproductive techniques (ART). Currently,
gonadotropins are the most important tools to proceed with ovarian stimulation for all purposes, including ART and
anovulation disorders, like
hypogonadotropic hypogonadism and hypothalamic hypophyseal dysfunction.
Gonadotropin preparations derived from human urine have been used clinically since the early 1960s and the first urine-derived preparation containing only FSH (
urofollitropin) became available in 1983. More recently, the application of
recombinant DNA technology has resulted in the development of recombinant FSH produced in mammalian cells. In the last period, LH became available by
recombinant DNA technology and is now a new option for protocols of ovarian stimulation. Treatment with
gonadotropins has been shown to be effective in males affected by
hypogonadotropic hypogonadism. This success has resulted in attempts to utilize FSH
therapy in oligozoospermic men, aimed at obtaining a quantitative increase in sperm count. The purpose of this review was to examine the pharmacological aspects and different clinical applications of recombinant
gonadotropins (FSH, LH, hCG) in the treatment of
female infertility in all its aspects and their use also in the treatment of
male infertility. This review will trace these events, from the past through to the present, and conclude with a glance towards the future.