ABSTRACT
The first successful in vitro fertilization attempt and most treatment cycles for a while thereafter were conducted in spontaneous menstrual cycles. Nevertheless, realization that availability of a crop of mature oocytes markedly increased chances of success in this therapy, prompted most centers to adopt some form of Controlled Ovarian Hyperstimulation (COH). At the outset, clomiphene citrate alone or in combination with human menopausal gonadotropins (hMG) was used but eventually exogenous gonadotropins emerged as the sole stimulatory drug for COH. Exogenous gonadotropins, and specifically hMG products, have been used in the treatment of infertility since the 1960’s, when the first hMG product became available. Subsequently, over the last 20 years they have become the mainstay of fertility treatment worldwide. The gonadotropins are indicated in isolation as a treatment to induce ovulation, normally in cases where clomiphene has failed, or as a first-line treatment in specific cases of amenorrhea. They are also indicated for hypogonadotropic hypogonadism in men and women. The most widespread use of gonadotropins is for women undergoing superovulation within a medically assisted reproductive program, such as IVF. Superovulation is the stimulation of the ovaries to produce more than one follicle, which enables several embryos to be created.
