Luteinizing hormone

Summary

Luteinizing hormone (LH) is an endogenous pituitary glycoprotein gonadotropin consisting of alpha and beta subunits. Recombinant human LH (r-hLH, lutropin alfa) and urinary-derived LH preparations are used clinically for the treatment of infertility in women with profound LH deficiency and in assisted reproductive technology (ART) protocols, typically in combination with FSH.

Mechanism of Action

Binds to LH receptors (LHR/LHCGR) on Leydig cells in the testes and theca cells in the ovaries, stimulating steroidogenesis via cAMP/PKA signaling; triggers ovulation by inducing the LH surge, promotes testosterone synthesis in males, and supports progesterone production in the corpus luteum in females.

Routes of Administration

Goals & Uses

• Male hypogonadism / testosterone deficiencyMale Reproductive HealthModerate
• Induction of follicular development in LH-deficient womenReproductive Endocrinology / FertilityHigh
• Spermatogenesis induction in hypogonadotropic hypogonadismMale FertilityModerate
• Assisted reproductive technology (ART) stimulationReproductive Endocrinology / FertilityHigh
• Triggering ovulation / luteinizationReproductive EndocrinologyHigh

Contraindications

• Primary ovarian failure / primary hypogonadismEndocrineHigh
• Hormone-sensitive tumors (e.g., ovarian, uterine, testicular cancer)OncologyHigh
• PregnancyPopulationHighPotential fetal risk or insufficient safety data
• Hypersensitivity to gonadotropins or excipientsAllergy/ImmunologyHigh
• Ovarian cysts or enlarged ovaries (not due to PCOS)ReproductiveModerate
• Uncontrolled thyroid or adrenal dysfunctionEndocrinologyModerate

Adverse Effects

• Injection site reactionsLocalCommon
• Multiple gestationReproductiveUncommon
• HeadacheNeurologicCommonPain in the head or upper neck
• Ectopic pregnancyReproductive / ObstetricRare
• Abdominal pain / bloatingGastrointestinalCommon
• Ovarian hyperstimulation syndrome (OHSS)ReproductiveUncommon

Drug Interactions

• Human Chorionic Gonadotropin (hCG)Moderate
• GnRH agonists (e.g., leuprolide, buserelin)Low
• Recombinant FSH (follitropin alfa/beta)Low
• GnRH antagonists (e.g., cetrorelix, ganirelix)Low

Population Constraints

• Women with polycystic ovary syndrome (PCOS)Endocrine / ReproductiveRelative
• Prepubertal individualsPediatricAbsolute
• Elderly patientsAgeRelative
• Pregnant womenReproductiveAbsolute
• Patients with renal or hepatic impairmentOrgan FunctionRelative

Regulatory Status

• European UnionApprovedApproved: Stimulation of follicular development in women with severe LH and FSH deficiency (hypogonadotropic hypogonadism) in combination with FSHLuveris (lutropin alfa) centrally approved by EMA; indicated for use with Gonal-f
• United StatesApprovedApproved: Stimulation of follicular development in infertile hypogonadotropic hypogonadal women with profound LH deficiency (in combination with Gonal-F)Lutropin alfa (Luveris) approved by FDA; urinary-derived hMG preparations also approved
• United KingdomApprovedApproved: Stimulation of follicular development in LH and FSH-deficient women in combination with FSHApproved by MHRA post-Brexit; Luveris retains authorization in the UK

Lutropin alfa (Luveris) is EMA- and FDA-approved for stimulation of follicular development in LH-deficient women. Urinary-derived gonadotropin combinations containing LH activity (e.g., Menopur, hMG) are also approved. Recombinant LH is classified as a prescription biological product in most jurisdictions.

Evidence & Sources

No sources recorded yet.