ATC Group: G03G Gonadotropins and other ovulation stimulants

The principal pharmacodynamic activity in women is oocyte meiosis resumption, follicular rupture (ovulation), corpus luteum formation and production of progesterone and estradiol by the corpus luteum.

Human chorionic gonadotrophin stimulates the steroidogenesis in the gonads by virtue of a biological effect similar to that of LH (Luteinizing hormone, which is the same as interstitial cell stimulating hormone).

Clomifene is a non-steroidal agent which stimulates ovulation in a high percentage of appropriately selected anovulatory women. The ovulatory response to clomifene therapy is mediated through increased output of pituitary gonadotrophins, which in turn stimulates the maturation and endocrine activity of the ovarian follicle.

Corifollitropin alfa is designed as a sustained follicle stimulant with the same pharmacodynamic profile as (rec)FSH, but with a markedly prolonged duration of FSH activity. Corifollitropin alfa does not display any intrinsic LH/hCG activity.

In women, the most important effect resulting from parenteral administration of FSH is the development of mature Graafian follicles.

Follitropin beta is a recombinant FSH. Follitropin beta can be used to stimulate follicular development and steroid production in selected cases of disturbed gonadal function. Furthermore follitropin beta can be used to promote multiple follicular development in medically assisted reproduction programs.

Follitropin delta is a recombinant human FSH used for controlled ovarian stimulation for the development of multiple follicles in women undergoing assisted reproductive technologies (ART). Because follitropin delta is produced in the human cell line PER.C6, the glycosylation profile is different from follitropin alfa and follitropin beta.

Lutropin alfa is a recombinant human Luteinising Hormone (r-hLH). Luteinising Hormone (LH) binds on the ovarian theca (and granulosa) cells and testicular Leydig cells, to a receptor shared with human chorionic gonadotropin hormone (hCG). Lutropin alfa in association with a Follicle Stimulating Hormone (FSH) preparation is recommended for the stimulation of follicular development in adult women with severe Luteinising Hormone (LH) and FSH deficiency.

Urofollitropin contains a highly purified preparation of urinary FSH extracted from the urine of postmenopausal women. FSH stimulates ovarian follicular growth and development as well as gonadal steroid production in women who do not have primary ovarian failure.