Development and applications of luteinizing hormone-releasing hormone antagonists in the treatment of infertility

An overview

Th Reissmann, R. Felberbaum, K. Diedrich, J. Engel, A. M. Comaru-Schally, Andrew V Schally

Research output: Contribution to journalArticle

117 Citations (Scopus)

Abstract

Luteinizing hormone-releasing hormone (LHRH) plays a crucial role in controlling the ovarian cycle in women. By modification of the molecular structure of this decapeptide, analogues were synthesized with agonistic or antagonistic effects on the gonadotrophic cells of the anterior pituitary gland. The agonists, after an initial stimulatory effect ('flare up'), lead to desensitization of the gonadotrophic cells and a reduction in the number of LHRH receptors on the cell membrane ('down-regulation'), while the antagonists produce an immediate effect by competitive blockade of the LHRH receptors. After administration of LHRH antagonists, the serum levels of FSH and LH decrease within hours. Nevertheless, the adenohypophysis maintains its responsiveness to an LHRH stimulus ('pituitary response') after pretreatment with an antagonist. This different pharmacological mechanism of LHRH antagonists makes possible new approaches to ovarian stimulation and to the therapy of sex steroid dependent diseases. The premature LH surge, the main cause of cancellation during induction of superovulation in assisted reproduction technology (ART) programmes, can be abolished by short term application of an LHRH antagonist associated with a reduced human menopausal gonadotrophin (HMG) requirement for ovarian stimulation. A future approach to ART might be based on the combination of pretreatment with an LHRH antagonist and ovulation induction by native LHRH or an agonist. The severe side effects encountered with early LHRH antagonists, such as anaphylactoid reactions due to histamine release, are almost completely eliminated in modern antagonists, especially Cetrorelix which is presently used clinically in controlled phase II clinical studies.

Original languageEnglish
Pages (from-to)1974-1981
Number of pages8
JournalHuman Reproduction
Volume10
Issue number8
StatePublished - Sep 26 1995
Externally publishedYes

Fingerprint

Hormone Antagonists
Infertility
Hormones
Gonadotropin-Releasing Hormone
Ovulation Induction
LHRH Receptors
Anterior Pituitary Gland
Therapeutics
Reproduction
Superovulation
Menotropins
Technology
Ovarian Stimulation
Histamine Release
Menstrual Cycle
Molecular Structure
Cell membranes
Down-Regulation
Pretreatment
Induction

Keywords

  • Competitive blockade
  • GnRH
  • GnRH antagonists
  • Pituitary response
  • Receptor down-regulation

ASJC Scopus subject areas

  • Physiology
  • Developmental Biology
  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Physiology (medical)
  • Rehabilitation

Cite this

Reissmann, T., Felberbaum, R., Diedrich, K., Engel, J., Comaru-Schally, A. M., & Schally, A. V. (1995). Development and applications of luteinizing hormone-releasing hormone antagonists in the treatment of infertility: An overview. Human Reproduction, 10(8), 1974-1981.

Development and applications of luteinizing hormone-releasing hormone antagonists in the treatment of infertility : An overview. / Reissmann, Th; Felberbaum, R.; Diedrich, K.; Engel, J.; Comaru-Schally, A. M.; Schally, Andrew V.

In: Human Reproduction, Vol. 10, No. 8, 26.09.1995, p. 1974-1981.

Research output: Contribution to journalArticle

Reissmann, T, Felberbaum, R, Diedrich, K, Engel, J, Comaru-Schally, AM & Schally, AV 1995, 'Development and applications of luteinizing hormone-releasing hormone antagonists in the treatment of infertility: An overview', Human Reproduction, vol. 10, no. 8, pp. 1974-1981.
Reissmann, Th ; Felberbaum, R. ; Diedrich, K. ; Engel, J. ; Comaru-Schally, A. M. ; Schally, Andrew V. / Development and applications of luteinizing hormone-releasing hormone antagonists in the treatment of infertility : An overview. In: Human Reproduction. 1995 ; Vol. 10, No. 8. pp. 1974-1981.
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