The GnRH challenge test: a quantitative measure of pituitary desensitization during GnRH agonist administration

Contraceptive efficacy and dose-response effects of the gonadotrophin-releasing hormone (GnRH) agonist deslorelin in Tasmanian devils (Sarcophilus harrisii)

Contraception is increasingly used to manage breeding opportunities in conservation-dependent species. This study aimed to determine the efficacy, duration of effect, optimal dose and potential side effects of Suprelorin contraceptive implants in Tasmanian devils, for use in the conservation breeding program. In our pilot study, Suprelorin was found to effectively suppress oestrous cycles in female devils, yet caused a paradoxical increase in testosterone in males. Therefore, we focussed on females in further trials. Females received one (n=5), two (n=5) or no (n=5) Suprelorin implants, with quarterly gonadotrophin-releasing hormone (GnRH) challenges used to test pituitary responsiveness over two breeding seasons. Both Suprelorin doses suppressed pituitary responsiveness for at least one breeding season, with a reduced effect in the second. There was a dose-response effect on duration rather than magnitude of effect, with high-dose devils remaining suppressed for longer than low-dose animals. There were no apparent negative effects on general health, yet captivity and contraception together may cause weight gain. Suprelorin contraceptive implants are now routinely used in the Save the Tasmanian Devil Program insurance metapopulation to meet the aims of maintaining genetic and behavioural integrity by controlling individual reproductive contributions in group housing situations.

Finding the Balance: Fertility Control for the Management of Fragmented Populations of a Threatened Rock-Wallaby Species

Simple Summary

Black-flanked rock-wallabies (Petrogale lateralis lateralis) can reach high numbers in fragmented populations in the West Australian wheat-belt, where they can damage crops and cause habitat degradation. As they are threatened, we wanted a non-permanent control method that did not adversely affect the body condition of treated females compared to untreated females, using body condition as an indicator of general health and fitness. We gave adult female rock-wallabies deslorelin contraceptive implants to suppress their fertility and monitored the impact for three years. Treated females did not conceive new young for over two years. We did not detect any negative effects on body condition, suggesting that deslorelin may be an effective tool for managing overabundant populations of marsupials.

Abstract

Populations of Australian marsupials can become overabundant, resulting in detrimental impacts on the environment. For example, the threatened black-flanked rock-wallaby (Petrogale lateralis lateralis) has previously been perceived as overabundant and thus ‘unwanted’ when they graze crops and cause habitat degradation. Hormonally-induced fertility control has been increasingly used to manage population size in other marsupials where alternative management options are not viable. We tested whether deslorelin, a superagonist of gonadotropin-releasing hormone (GnRH), would suppress reproduction in free-living adult female rock-wallabies without adversely impacting body condition. We trapped, synchronised reproduction and allocated female rock-wallabies to a placebo implant (control, n = 22), one (n = 22) or two (n = 20) subcutaneous implants of deslorelin. Females were then recaptured over the following 36 months to monitor reproduction, including Luteinising Hormone levels, and body condition. Following treatment, diapaused blastocysts reactivated in five females and the resulting young were carried through to weaning. No wallabies treated with deslorelin, conceivede a new young for at least 27 months. We did not observe adverse effects on body condition on treated females. We conclude that deslorelin implants are effective for the medium-term suppression of reproduction in female black-flanked rock-wallabies and for managing overabundant populations of some marsupials.

Resumption of menstruation and pituitary response to gonadotropin-releasing hormone in functional hypothalamic amenorrhea subjects undertaking estrogen replacement therapy

BACKGROUND

Functional hypothalamic amenorrhea (FHA) refers to a functional menstrual disorder with various causes and presentations. Recovery of menstrual cyclicity is common in long-term follow-up but the affecting factors remain unknown.

AIM

To explore factors affecting the menstrual resumption and to evaluate the pituitary response to gonadotropin-releasing hormone (GnRH) in FHA.

MATERIALS AND METHODS

Thirty cases with FHA were recruited. All subjects were put on continuous 1 mg/day estradiol valerate orally and followed up monthly. Recovery was defined as the occurrence of at least three consecutive regular cycles. Responder referred to those who recovered within two years of therapy. Gonadotropin response to the 50 μg GnRH challenge was tested every three months.

RESULTS

Nineteen (63.3%) subjects recovered with a mean time to recovery of 26.8 months. Time to recovery was negatively correlated with body mass index (BMI) before and by amenorrhea. Twentyone cases had undertaken therapy for more than two years and 10 of them recovered. BMI before and by amenorrhea were negatively correlated with the recovery. Significant increase of serum luteinizing hormone (LH) and LH response to GnRH were noted after recovery.

CONCLUSIONS

Menstrual resumption was common in FHA undertaking estrogen replacement therapy (ERT). The likelihood of recovery was affected by their BMI before and by amenorrhea but not by the weight gain during therapy. Low serum LH and attenuated LH response to GnRH were the main features of pituitary deficiency in FHA. The menstrual resumption in FHA was accompanied by the recovery of serum LH and the LH response to GnRH.

The mechanism responsible for the supraphysiologic gonadotropin surge in females treated with gonadotropin-releasing hormone (GnRH) agonist and primed with GnRH antagonist

OBJECTIVE

To elucidate the physiologic mechanism responsible for the supraphysiologic gonadotropin release from the pituitary induced by gonadotropin-releasing hormone (GnRH) agonist in female rats primed with GnRH antagonist.

DESIGN

Controlled experimental intervention.

SETTING

Government research facility.

ANIMAL(S)

Forty 8-week-old Sprague-Dawley rats.

INTERVENTION(S)

Forty oophorectomized rats were randomized into four treatment groups of 10: group A, control vehicles; group B, GnRH agonist (leuprolide acetate; 1.7 microg/kg twice a day) on day 4; group C, GnRH antagonist (Nal-Lys; 3 mg/kg each day) days 1 to 4; or group D, GnRH antagonist (Nal-Lys; 3 mg/kg each day) days 1 to 4 plus GnRH agonist (1.7 microg/kg twice a day) on day 4.

MAIN OUTCOME MEASURE(S)

Immunohistochemical methods, Northern and in situ hybridization to quantitate pituitary follicle-stimulating hormone beta (FSH-beta), luteinizing hormone beta (LH-beta), and GnRH receptor (GnRH-R) messenger RNA (mRNA), and receptor protein levels in all treatment groups.

RESULT(S)

Treatment with GnRH antagonist was associated with increased storage of gonadotropin in the pituitary for FSH-beta and LH-beta, but mRNA levels were unchanged. The GnRH-R mRNA decreased after GnRH-agonist treatment but remained stable in the GnRH-antagonist treatment groups. Levels of GnRH-R were decreased after GnRH-antagonist treatment.

CONCLUSION(S)

These data indicate that the in vivo mechanism responsible for the exaggerated release of gonadotropins in rats primed with GnRH antagonist and treated with GnRH agonist was an increase in releasable gonadotropin pools coupled with a reduction in GnRH-R, but receptor function was preserved.

Effects of deslorelin implants on reproduction in the common brushtail possum (Trichosurus vulpecula)

The present study investigated the effects of slow-release implants containing the gonadotrophin-releasing hormone (GnRH) agonist deslorelin on reproduction in the common brushtail possum (Trichosurus vulpecula). Captive female brushtail possums were assigned to control (placebo implant), low dose (4.7 mg deslorelin) or high dose (9.4 mg deslorelin) groups; males were assigned to control or high dose (9.4 mg deslorelin) groups. The acute effects of deslorelin treatment at the level of the pituitary gland were similar between the two sexes, where a transient rise in luteinising hormone concentration was induced over the first 24 h. In females, this was associated with the disruption of the normal oestrous cycle and mating within 2–10 days in some treated individuals, but no young were subsequently detected. By 3 weeks after treatment, treated females became anoestrus and remained infertile for at least one breeding season. The effects of treatment were reversible in a subset of females that had their implants removed, although the time taken to produce offspring was variable. Paradoxically, male brushtail possums remained fertile during chronic deslorelin exposure. Despite significant declines in basal follicle-stimulating hormone and testosterone concentrations, as well as an inability to respond to a GnRH challenge, treated males sired as many offspring as control males and there was no evidence of testicular regression. In conclusion, there is potential to control reproduction in female brushtail possums by using chronic GnRH agonist treatment.

Fertility control in female eastern grey kangaroos using the GnRH agonist deslorelin. 2. Effects on behaviour

In recent years fertility control has been proposed as an ethically acceptable alternative to lethal control techniques when managing overabundant kangaroo populations. A promising non-steroidal, non-immunological approach to contraception in female kangaroos involves the use of slow-release implants containing the gonadotrophin-releasing hormone (GnRH) agonist deslorelin. The practicality of using deslorelin implants as a management option is dependant on its effective inhibition of reproduction without negative physical or behavioural side-effects. This study investigated the behavioural effects of deslorelin implants in female eastern grey kangaroos. Treatment had no detectable effects on crepuscular activity. Alterations in the frequency of sexual interactions were observed in deslorelin-treated females, with a behavioural oestrus induced ~3 days after combined removal of pouch young and deslorelin administration. Copulation was observed during this early oestrous period, but conception was not achieved and pouch young were not observed in any treated females. Control females gave birth within 69.6 ± 10.4 days (mean ± s.e.m., n = 9) of placebo implant administration. The first births observed in treated animals were on Days 510, 637 and 643 after treatment. The remaining seven treated animals had not bred by the end of the study, a period of 647 days.

Subcutaneous administration of pulsatile gonadotropin-releasing hormone decreases serum follicle-stimulating hormone and luteinizing hormone levels in women with polycystic ovary syndrome: A preliminary study

OBJECTIVE

The main objectives of this study were to investigate whether [1] subcutaneous (SC) administration of pulsatile gonadotropin-releasing hormone (GnRH) decreases the increased levels of luteinizing hormone (LH) observed in women with polycystic ovary syndrome (PCOS); and [2] GnRH administration modifies the pattern of LH secretion observed in these patients.

DESIGN

Serum follicle-stimulating hormone (FSH) and LH levels and LH pulse amplitude and pulse interval were determined in 13 patients with PCOS during the first 3 days of the cycle following the administration of 10 mg of medroxyprogesterone acetate during 5 days.

SETTING

Infertility clinic.

PATIENT(S)

Thirteen women with PCOS.

INTERVENTION(S)

Determination of FSH and LH serum levels after SC administration of pulsatile GnRH.

MAIN OUTCOME MEASURE(S)

The FSH and LH levels in serum.

RESULT(S)

Mean FSH and LH levels in serum decreased following the administration of subcutaneous pulsatile GnRH in all treated women compared with baseline values. The LH pulse amplitude and pulse interval decreased in all patients following the administration of pulsatile GnRH.

CONCLUSION(S)

The SC administration of pulsatile GnRH in women with PCOS significantly decreases FSH and LH levels in serum. A decrease in the secretion of gonadotropins, without reaching the intense suppression observed with GnRH analogues, could be of great utility in in vitro fertilization (IVF) treatments.

Subcutaneous administration of a depot gonadotropin-releasing hormone agonist induces profound reproductive axis suppression in women

OBJECTIVE

To compare the i.m. and s.c. routes of depot GnRH agonist administration.

DESIGN

Prospective, controlled pharmacokinetics study.

SETTING

Volunteers in an academic research environment.

PATIENT(S)

Forty women with benign gynecologic disorders.

INTERVENTION(S)

Triptorelin administration (3.75 mg) at 28-day intervals for 6 consecutive months. Twenty patients were treated with IM triptorelin, and 20 patients were treated with SC triptorelin.

MAIN OUTCOME MEASURE(S)

Assessment of side effects, GnRH test results, and triptorelin, LH, FSH, estradiol, and progesterone levels.

RESULT(S)

The occurrence of injection site redness and itching and of some hypoestrogenic side effects was increased significantly in the SC group. Plasma triptorelin levels were significantly higher in the IM group in the first month of treatment; thereafter, the pattern reversed, with a nonsignificant trend toward higher plasma triptorelin levels in the SC group. Serum LH, FSH, estradiol, and progesterone levels were low after the first month of treatment and did not differ between the two treatment groups. On day 196 (2 months after the last depot triptorelin injection), triptorelin was still measurable and gonadotropins and gonadal steroids were still suppressed. Spontaneous menses returned significantly later in the SC group than in the IM group.

CONCLUSION(S)

Subcutaneous triptorelin can be administered by the patient. Both IM and SC triptorelin administration are cliniclly effective, but they result in different triptorelin pharmacokinetics. Subcutaneous triptorelin is associated with more prolonged amenorrhea than is IM triptorelin, suggesting enhanced pituitary-ovarian suppression. These results suggest that SC triptorelin may allow lower drug dosage administration and/or longer administration intervals.