Feature Review Gonadotropins as pharmacological agents in assisted reproductive technology and polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy associated with subfertility/infertility and pregnancy complications. Most PCOS women opt for assisted reproductive technologies (ART) for successful conception; however, optimization of the relative doses of the gonadotropins [follicle-stimulating hormone (FSH), luteinizing hormone (LH)/human chorionic gonadotropin (hCG)] for appropriate steroidogenesis, without causing ovarian hyperstimulatory syndrome (OHSS), is challenging. Embryonic factors probably do not contribute to pregnancy loss in PCOS women, albeit hormonal imbalance impairs the metabolic microenvironment critical for oocyte maturation and endometrial receptivity. Certain clinical studies have confirmed the role of metabolic corrections in increasing the rate of pregnancy in PCOS women. This review focuses on the impact of untimely high LHCGR and/or LH levels on oocyte/embryo quality, pregnancy outcomes in ART, and exploring LHCGR as a potential drug target in PCOS women.

Automated summary

Polycystic ovary syndrome (PCOS) is a complex endocrinopathy that affects fertility and pregnancy outcomes. Assisted reproductive technologies (ART) are commonly used by PCOS women for successful conception, but finding the right hormone doses to optimize steroidogenesis without causing adverse effects is challenging. Metabolic corrections have been shown to improve pregnancy rates in PCOS women, and this review explores the role of high LHCGR and/or LH levels in oocyte/embryo quality and the potential of targeting LHCGR as a drug therapy for PCOS.