Emerging drugs in assisted reproduction.
Infertility affects approximately 15% of couples of reproductive age. In assisted reproductive technology (ART), medications play a crucial role in stimulating ovaries to produce several oocytes and prepare the endometrium to be receptive after replacing one or more embryos into the uterine cavity. The availability of recombinant human follicle stimulating hormone, luteinising hormone and human chorionic gonadotrophin; of gonadotrophin-releasing hormone (GnRH) agonists and antagonists; and of luteal supplementation with progesterone have allowed the tailoring of several stimulation schemes, which have enhanced the pregnancy outcome after ART treatment. However, the remaining risk of ovarian hyperstimulation syndrome, the still low implantation rates, the unacceptably high rates of multiple pregnancies and the daily parenteral administration of medications do not constitute the features of a patient-friendly procedure. Therefore, a number of molecules with gonadotrophin-like activity, inhibition of GnRH receptor ability, or endometrium receptivity enhancement properties are currently under active investigation. Orally bioactive therapeutic preparations, in particular, may revolutionize in vitro fertilisation (IVF) treatment in the near future. Nevertheless, the implementation of mild ovarian stimulation protocols with single embryo transfer policy and further development of oocyte in vitro maturation techniques may lead to a less drug orientated IVF treatment.
Papanikolaou
Evangelos G
EG
AZ-VUB, University Hospital, Dutch-speaking Brussels Free University Centre for Reproductive Medicine, Laarbeeklaan 101, 1090 Jette, Brussels, Belgium. Evangelos.Papanikolaou@vub.ac.be
Kolibianakis
Efstratios
E
Devroey
Paul
P
D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004345:Drug Industry / Q000639:trends*; D015507:Drugs, Investigational / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D005299:Fertility Agents / Q000737:chemistry / Q000627:therapeutic use*; D005307:Fertilization in Vitro / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000378:metabolism; D016471:Ovarian Hyperstimulation Syndrome / Q000188:drug therapy / Q000378:metabolism; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D027724:Reproductive Techniques, Assisted / Q000706:statistics & numerical data
D015507:Drugs, Investigational; D005299:Fertility Agents