Gonadotropins in the treatment of infertility

1. Monitoring of gonadotropin therapy is essential to reduce the risk of hyperstimulation and multiple pregnancies. Biochemical methods for the measurement of estrogen production should be done in conjunction with ultrasonic scanning of the growing follicles. 2. The joint action of clomiphene and gonadotropins has not been adopted for routine gonadotropin therapy but is useful for inducing multiple ovulations in women undergoing in vitro fertilization. 3. Pulsatile administration of gonadotropins has not been shown to avoid multiple follicular development and therefore has no advantage over routine methods of administration. 4. Gonadotropin preparations with a high ratio of FSH to LH would theoretically be more suitable for the treatment of polycystic ovarian disease than the usual preparations with a 1:1 ratio on account of the high basal LH levels in these patients. In experiments so far the results obtained have been no better however.