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Gonadotropins – FSH, LH and HCG explained

Gonadotropins are hormones that regulate the function of the gonads. They play a central role in reproduction and hormonal balance in both men and women.

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Things worth knowing about "Gonadotropins"

Gonadotropins are hormones that regulate the function of the gonads. They play a central role in reproduction and hormonal balance in both men and women.

What Are Gonadotropins?

Gonadotropins are a group of hormones that regulate the activity of the gonads – the ovaries in women and the testes in men. They are primarily produced and controlled by the pituitary gland located at the base of the brain. The most important gonadotropins are Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH). A third major gonadotropin is Human Chorionic Gonadotropin (HCG), which is produced by the placenta during pregnancy.

Biological Functions

Gonadotropins perform essential roles in the reproductive system:

FSH (Follicle-Stimulating Hormone): In men, FSH stimulates sperm production (spermatogenesis). In women, it promotes the growth of ovarian follicles containing the egg cells.
LH (Luteinizing Hormone): In men, LH triggers testosterone production in the testes. In women, a surge in LH triggers ovulation and supports the formation of the corpus luteum (yellow body) after the egg is released.
HCG (Human Chorionic Gonadotropin): HCG maintains the corpus luteum in early pregnancy to ensure adequate progesterone production. It is also the hormone detected by pregnancy tests.

Regulation of Gonadotropins

The production of FSH and LH is controlled by the hypothalamus, which releases Gonadotropin-Releasing Hormone (GnRH). This signal prompts the pituitary gland to secrete FSH and LH. The system operates as a feedback loop: when the gonads produce sufficient sex hormones, the release of gonadotropins is reduced (negative feedback).

Clinical Relevance

Disorders of Gonadotropin Balance

An imbalance in gonadotropin levels can lead to various medical conditions:

Pituitary insufficiency: Low FSH and LH production can cause infertility, reduced libido, and menstrual irregularities.
Polycystic Ovary Syndrome (PCOS): An abnormal FSH/LH ratio is a hallmark of this common hormonal disorder in women.
Hypogonadism: Insufficient gonadotropin levels can lead to reduced gonadal function in both men and women.
Menopause: After the last menstrual period, FSH and LH levels rise significantly because the negative feedback from estrogen is absent.

Diagnostic Use

Measuring FSH, LH, and HCG in blood or urine is a key diagnostic tool in gynecology, urology, and endocrinology. Elevated HCG levels indicate pregnancy but can also signal certain types of tumors.

Therapeutic Use

Synthetic or urine-derived gonadotropins are used in reproductive medicine to stimulate ovarian function, for example in:

In vitro fertilization (IVF / ICSI)
Intrauterine insemination (IUI)
Hormone-related infertility in both men and women

Common preparations include recombinant FSH (e.g., follitropin alfa), Human Menopausal Gonadotropin (HMG), and HCG as a trigger for ovulation. These treatments are strictly medically supervised because of risks such as Ovarian Hyperstimulation Syndrome (OHSS).

References

Simoni, M. et al. – Gonadotropins and their receptors: Impact on the development of targeted therapies. Journal of Endocrinology, 2023. Available at PubMed: https://pubmed.ncbi.nlm.nih.gov/
World Health Organization (WHO) – Infertility definitions and terminology. Available at: https://www.who.int/reproductivehealth/topics/infertility/en/
Speroff, L. & Fritz, M.A. – Clinical Gynecologic Endocrinology and Infertility, 8th edition, Lippincott Williams & Wilkins, 2011.

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