The evolution of new agents for ovulation induction

The field of clinical ovulation-induction therapy has remained relatively static for over 30 years. This field promises to benefit from advances in our understanding of the biology of ovulation, and from exciting new work in the areas of molecular and cellular biology and in the biochemistry of steroids, gonadotropins, and their receptors. New therapies with recombinant gonadotropins and their analogues show promise for the near future. Advances in our ability to stimulate and suppress the reproductive axis through central mechanisms also show some promise. In the long term, our understanding of the mechanisms involved in folliculogenesis and oocyte maturation may be combined with an enhanced ability to dissect these processes that lead to disordered ovulation. Our improved understanding of the implantation process may well lead to an ability to create nearly universal nidation in women who are undergoing ART or who have implantation disorders. This article discusses some of the many new opportunities in the clinical and basic science of ovulation induction. New technologies, such as those available through the Human Genome Project, and the use of genetic manipulation of animal models will stimulate additional new avenues of research.