Gonadotropins for women with unexplained infertility

Abstract

The use of gonadotropins in the treatment of unexplained infertility for women, who are apparently ovulating regularly, appears logically to be a futile exercise. However, whether by correcting subtle deficiencies in the ovulation process, improving the endocrine environment, and/or endometrial receptivity, ovarian stimulation with gonadotropins produces better pregnancy rates than either clomiphene citrate alone or intrauterine insemination (IUI) alone. When gonadotropin stimulation was combined with IUI, it produced superior pregnancy rates than either clomiphene citrate and IUI or IUI alone. It has been suggested, however, that gonadotropin stimulation combined with IUI does not produce superior birth rates compared with expectant treatment. Due to a lack of evidence-based studies in this field, the use of gonadotropin stimulation in the treatment of unexplained infertility, although now widely employed, remains controversial and further well-designed studies are needed.