Gonadotropin-releasing hormone and its analogues

Article Abstract:

Gonadotropin-releasing hormone (GnRH), first characterized in 1971, was rapidly made available by the Food and Drug Administration to treat diseases, as well as endocrine and reproductive disorders. A review is presented of the factors that govern the production of GnRH; the response of the body's cells to the hormone; its clinical uses; and pharmacological data concerning its effects. GnRH is made in the hypothalamus (part of the brain), then transported to the anterior pituitary (the master endocrine gland) where it stimulates cells to release gonadotropins. These include luteinizing hormone and follicle-stimulating hormone, which travel to cells of the gonads (testes and ovaries) where they affect a variety of physiological processes. GnRH is released in a pulsatile fashion on an approximately hourly basis, and its half-life (the time required for half a given quantity to be metabolized) is less than five minutes, so measurement is difficult. GnRH antagonists are chemicals that bind to the GnRH receptor and prevent binding by GnRH; they do not produce any physiological consequence, however. Several events follow the occupation of GnRH receptors by GnRH or its agonists: regulation of these processes is discussed. The clinical uses of GnRH and GnRH-agonists (drugs that mimic the action of GnRH) include restoration of fertility in men and women by GnRH pumps, and suppression of the pituitary-gonadal loop (biochemical castration) by continuous administration of GnRH. The latter goal is desirable in cases where gonadal hormones exacerbate another disorder, such as prostate cancer or endometriosis (presence of uterine lining tissue in sites other than the uterus), or for timing of ovulation (as for in vitro fertilization). Children with precocious puberty are also treated with GnRH agonists. The clinical uses of GnRH are discussed in detail. The hormone's pharmacokinetics and the chemical features of GnRH analogues and antagonists, with potential use as contraceptive agents, are presented. An extensive bibliography of relevant medical literature is included. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects

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Adult-onset idiopathic hypogonadotropic hypogonadism - a treatable form of male infertility

Article Abstract:

Some men who are infertile may have an acquired case of hypogonadotropic hypogonadism. This condition is characterized by a deficiency of gonadotropin-releasing hormone (GnRH), which is produced by the hypothalamus. It normally strikes in youth and prevents sexual maturation. Ten men who were sexually mature but infertile were found to have acquired hypogonadotropic hypogonadism. Their production of GnRH was deficient and fertility was restored in five men who received long-term treatment with GnRH. No anatomical abnormality could be found in these men.

Care and treatment, Causes of, Infertility, Male, Male infertility

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Reversal of idiopathic hypogonadotropic hypogonadism

Article Abstract:

Neuroendocrine and gonadal reversal after discontinuation of hormonal therapy in 15 men with characteristics of idiopathic hypogonadotropic hypogonadism is reported.

Patient outcomes, Hormone therapy, Clinical report

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