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Gonadotropin-Releasing Hormone and Its Analogues

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Textbook of Assisted Reproduction

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Abstract

GnRH secreted by the hypothalamus plays a key role in the regulation of the reproductive axis. Its normal pulsatile secretion is required for the pituitary release of FSH and LH hormones that regulate ovarian follicular activity. An intact multilevel feedback mechanism is required for normal function. Any disruption of this finely tuned endocrine axis results in abnormal ovarian function. GnRH analogues, agonists and antagonists, are now available and can be used to manage various clinical problems. GnRH analogues can be successfully used for the treatment of central precocious puberty, hormone-sensitive cancers, and various benign gynecologic conditions and play an important role in assisted reproduction. Their long-term use is not without side effects however; therefore future research has to focus on developing longer-acting formulas with proper add-back options that do not limit clinical efficacy but improve safety and allow long-term administration.

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Summary

GnRH secreted by the hypothalamus plays a key role in the regulation of the reproductive axis. Its normal pulsatile secretion is required for the pituitary release of FSH and LH hormones that regulate ovarian follicular activity. An intact multilevel feedback mechanism is required for normal function. Any disruption of this finely tuned endocrine axis results in abnormal ovarian function.

GnRH analogues, agonists and antagonists, are now available and can be used to manage various clinical problems. GnRH analogues can be successfully used for the treatment of central precocious puberty, hormone-sensitive cancers, and various benign gynecologic conditions and play an important role in assisted reproduction. Their long-term use is not without side effects however; therefore future research has to focus on developing longer-acting formulas with proper add-back options that do not limit clinical efficacy but improve safety and allow long-term administration.

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Authors and Affiliations

  1. Kaali Institute IVF Center, Budapest, Hungary

    Peter Kovacs

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  1. Peter Kovacs
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Editors and Affiliations

  1. Consultant Reproductive Endocrinology & IVF Millennium Medical Center MMC IVF, Dubai Health Care City, Dubai, United Arab Emirates

    Gautam Nand Allahbadia

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkey

    Baris Ata

  3. Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA

    Steven R. Lindheim

  4. X&Y Fertility, Leicester, UK

    Bryan J. Woodward

  5. School of Medicine and Dentistry, University of Rochester Medical Center, Newyork, USA

    Bala Bhagavath

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Kovacs, P. (2020). Gonadotropin-Releasing Hormone and Its Analogues. In: Allahbadia, G.N., Ata, B., Lindheim, S.R., Woodward, B.J., Bhagavath, B. (eds) Textbook of Assisted Reproduction. Springer, Singapore. https://doi.org/10.1007/978-981-15-2377-9_8

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