title: Gonadotropin therapy: a 20th century relic.
abstract: Gonadotropin therapy has been a cornerstone of infertility therapy for half a century. From the very beginning, its use has been associated with a high rate of multiple births, particularly high order multiples, and ovarian hyperstimulation syndrome. Initially, success rates seemed acceptable when used for superovulation (SO)/IUI therapy. However, as data from RCTs have emerged, reported outcomes suggest that we question the use of injectible gonadotropins. This manuscript examines the studies that have challenged gonadotropin use for SO/IUI and other research that supports reduced doses of gonadotropins for IVF. We examine the challenges for its continued use for SO/IUI and for moving to lower doses worldwide for IVF. We propose a future that views gonadotropins as a relic of the twentieth century.
authors.affiliation: Department of Obstetrics and Gynecology, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Reindollar
authors.forename: Marlene B
authors.initials: MB
authors.lastname: Goldman
mesh_terms: D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D006062:Gonadotropins / Q000009:adverse effects / Q000266:history / Q000627:therapeutic use*; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D007246:Infertility / Q000266:history / Q000503:physiopathology / Q000628:therapy*; D007315:Insemination, Artificial; D009099:Multiple Birth Offspring; D010062:Ovulation Induction / Q000009:adverse effects / Q000266:history / Q000639:trends; D011247:Pregnancy; D011272:Pregnancy, Multiple; D018570:Risk Assessment; D012307:Risk Factors; D013480:Superovulation; D016896:Treatment Outcome
chemical_list: D005300:Fertility Agents, Female; D006062:Gonadotropins