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Induction of Ovulation in Primate Models

Department of Obstetrics and Gynecology, State University of New York at Stony Brook Health Sciences Center Stony Brook, New York 11794-8091
Department of Obstetrics and Gynecology, George Washington University School of Medicine Washington, D.C. 20037
Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School Norfolk, Virginia 23507

Correspondence: Address reprint requests to: Gary D. Hodgen, Ph.D., Scientific Director, Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia 23507.

Abstract

IN 1958, Gemzell first described the use of a crude pituitary gonadotropin preparation in conjunction with human CG (hCG) for ovulation induction in anovulatory women. Two years later, Lunenfeld achieved a similar goal using human menopausal gonadotropin (hMG) plus hCG. Initially, fixed dose regimens were employed. Increasing experience with these agents soon demonstrated a considerable clinical and biochemical variation in response among patients undergoing ovulation induction therapy. Early on, this was attributed to the lack of consistency among preliminary gonadotropin preparations and to the different pathophysiological processes underlying the anovulatory state of such patients. The former's concern was addressed with the advent of highly purified preparations of gonadotropin. Indeed, owing to the limited availability of pituitary material, hMG containing an LH/FSH ratio of 1:1 (Pergonal, Serono, Randolph, MA) has emerged as the most widely used gonadotropin preparation. However, as endocrinologically normal women undertook treatment as in vitro fertilization and embryo transfer (IVF/ET) with this now standardized gonadotropin extract, the previously noted variation in response was seen to persist. This was manifest in the hormonal patterns which ensued as well as in the quantity and quality of oocytes recovered for IVF/ET.