It is well know that pituitary hormones FSH and LH are called gonadotropins because they act on the gonads (testicles-ovaries) and promote their function. Nowadays, synthetic and pharmaceutically produced pituitary gonadotropins are available which are administered for the development and maturation of multiple follicles. The drugs that are available are the recombinant and the urinary gonadotropins.
These hormones are administered by injection and they are commercially available:
- in a pre-mixed ready to used solution,
- in a powder that needs to be mixed with a special diluent in order to produce the injectable solutio
- pre-filled cartridge or pen-like syringe.
The pen-like syringe is marked in units so as the woman can administer subcutaneously the solution by herself with precision and safety.
They are new reproductive era drugs. Molecular biology has allowed pharmaceutical companies to apply the developments in recombinant DNA technology in drug production. Two forms of the human FSH gene have been isolated and they have been inserted and integrated in genetically modified cells. These cells can be cultured industrially and can therefore produce and release large quantities of natural human FSH, which can then easily be isolated in an almost pure chemical form.
Nowadays, these gonadotropins are available commercially under the generic name "recombinant FSH". Their commercial names are Puregon and Gonal-F. The chemical purity of these products allows their subcutaneous administration but the can also be administered intramuscularly. The way they are administered does not affect their biological action. The other gonadotropin called LH is also available as a product of the same technology with the commercial name Luveris.
They are "older" technology drugs. For many decades, gonadotropins that were used in assisted reproduction came from the urine of postmenopausal women. There was a complicated and expensive system in place for the collection of the urine (usually from women monasteries) and the isolation of hormones, a true struggle of the pharmaceutical industry of which little was known to the general public. With the sudden increase in gonadotropin demand due to the wider application of assisted reproduction, this system quickly reached its definite capacity, in the beginning of the 90's.
The drugs of that era contained a mixture of the two gonadotropins (FSH and LH) in various doses, with the generic name hMG (human menopausal gonadotropin) and were commercially available with the names Pergonal, Humegon, Pergogreen, Humegon FD. Their administration had to be done intramuscularly, due to their rather small grade of chemical purity. During the middle of the 90's, technology evolved and new drugs that contained purified FSH (Metrodin-HP) which were possible to be administered subcutaneously become commercially available. Nowadays, there are still urinary gonadotropins available for intramuscular or subcutaneous injection with the commercial names Altermon, Metrodin-HP and Menogon. Altermon is highly purified product and Menopur, Merional and Bravelle contain a mixture of FSH/LH in a 1:1 ratio.