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促性腺激素制剂使用的历史回顾

         

摘要

The history of gonadotropin administration reflects the development of technology and the deep understanding of the gonadotropin roles. From the use of pregnant mare serum, extracted product of pituitary, urinary-derived gonadotropins to recombinant gonadotropins, the protein was getting purer and finally devoid of other contaminating proteins. Based on the understanding of the luteinizing hormone (LH) role, the use of gonadotropins has gone through a course from a mixture of follicle-stimulating hormone (FSH) and LH to the purified FSH preparations, and to a recent return to mixtured preparations.The results of considerable clinic researchs showed that there were no significant differences in assisted reproductive technology (ART) outcomes between the preparations with or without LH. It is impossible to define the specific levels of " LH ceiling" and " LH threshold" in practice. The use of preparations containing LH could not cause high LH levels, so it didn't influence the outcomes of ART. The choice of gonadotropins depends on whether there exists a LH deficiency, such as hypogonadotropic hypogonadism, excess downregulation, poor responder and patients of advanced reproductive age. The other factor to be considered is the efficacy/value ratio.%促性腺激素(Gn)使用的历史是伴随着科学技术的发展和人们对Gn的作用逐步深入理解而不断地发生变化.随着科学技术的发展,人们从使用孕马血清、垂体提取物、尿Gn直至使用基因重组的Gn,尿杂质蛋白量逐渐减少直至完全消失[1],同时药物的消费额也增加了5倍多,从1995年是5百万欧元,到2000年的26.8百万欧元,而药物消费量增长则不到一倍[2].

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