An Overview on the Protocols used in the Management of Infertility

Abstract

Infertility is currently a huge burden in India. Artificial Reproductive Techniques (ART) are helpful for the couples in various cases of infertility. Various drugs are available today which includes ovulation inducing agents like clomiphene or letrozole, gonadotropins like Follicle Stimulating Hormone (FSH) and menotropins (Human Menopausal Gonadotropin; HMG) for follicular growth. Also, certain drugs are available, used for controlling the ovarian stimulation or causing hyperstimulation which includes Gonadotropin Releasing Hormone (GnRH) analogues. GnRH analogues especially the antagonists (e.g., Cetrorelix, Ganirelix) are the commonly used drugs for down regulating the gonadotropin production from the pituitary which eventually helps in avoiding the premature Luteinizing Hormone (LH) surges. These hormonal preparations like FSH, HMG are available as urinary (uFSH), Highly Purified (HP-FSH) and/or recombinant (rFSH) preparations. Even with the availability of so many drugs today, infertility management is a challenge to the doctors. Choosing a right protocol is still a widely debated topic and requires years of clinical experience. Currently there are no guidelines recommending the use of drugs which are available today. This overview helps in understanding the commonly used protocols in the management of infertility.

Keywords

• antagonist
• cetrorelix
• follicle stimulating hormone
• gonadotropin releasing hormone