Gonadotropin-releasing hormone (GnRH) for infertility

Examples

Generic Name	Brand Name
gonadotropin-releasing hormone	Factrel, Lutrepulse

How It Works

Gonadotropin-releasing hormone (GnRH) is produced by the hypothalamus. It stimulates the pituitary gland to produce luteinizing hormone (LH) and, to a lesser extent, follicle-stimulating hormone (FSH).

Why It Is Used

GnRH treatment is commonly used:

• When clomiphene (Clomid) treatment has not stimulated egg follicles to develop on the ovaries.

GnRH works most effectively when used to replace the natural GnRH in women and men whose bodies do not produce enough of it. GnRH may be given:

• To a woman who is not ovulating because her hypothalamus is not stimulating hormones that trigger ovulation (hypothalamic amenorrhea).
• To a man who is not producing sperm because his hypothalamus is not stimulating the hormones that trigger sperm production.

How Well It Works

GnRH use results in few multiple pregnancies (usually twins).

About 1% to 2% of infertile men have a gonadotropin insufficiency. GnRH is an effective treatment for this specific condition.¹

Side Effects

• Itching and redness at the site of injection
• Infection at the site of injection
• Ovarian hyperstimulation syndrome (rare)

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

GnRH poses less risk of ovarian hyperstimulation syndrome than does human menopausal gonadotropin (hMG), another treatment for ovulation problems. However, the small pump used for GnRH may be bothersome to some people. Conversely, hMG treatment requires daily monitoring by a doctor.

GnRH is used very rarely for women who have no menstrual cycle because of a hypothalamus problem (hypothalamic amenorrhea). Some reproductive endocrinologists might try human menopausal gonadotropin (hMG) instead of GnRH.

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Author:	Shannon Erstad, MBA/MPH Carrie Henley	Last Updated: August 16, 2006
Medical Review:	Adam Husney, MD - Family Medicine Joy Melnikow, MD, MPH - Family Medicine Kirtly Jones, MD - Obstetrics and Gynecology Femi Olatunbosun, MB, FRCSC - Obstetrics, Gynecology and Reproductive Medicine
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