LH-RH analogues: I. Their impact on reproductive medicine.

In the 28 years that have passed since the elucidation of the structure of luteinizing hormone-releasing hormone (LH-RH), diverse clinical applications in the field of reproductive medicine and related fields have been established for agonists of LH-RH, based on inhibition of the pituitary-gonadal axis. Various clinical investigations with agonists of LH-RH in benign gynecologic disorders, polycystic ovary disease (PCOD), in vitro fertilization-embryo transfer (IVF-ET), benign prostatic hypertrophy (BPH), precocious puberty and contraception were reviewed. LH-RH antagonists inhibit LH, follicle-stimulating hormone (FSH), and sex steroid secretion immediately after their administration and thus achieve rapid therapeutic effects. LH-RH antagonists should find applications in the treatment of uterine leiomyomas, endometriosis, and in controlled ovarian stimulation-assisted reproductive techniques (COS-ART), which have been already established for the agonists. Modern LH-RH antagonists such as cetrorelix may prove superior to the agonists in COS-ART and also in the treatment of BPH, but additional studies in these and other areas are needed.