Gonadotropins

Professional guidelines generally recommend ovulation stimulation with IUI using oral agents while discouraging gonadotropin-IUI due to safety concerns, yet real-world practice varies considerably. Gonadotropins can increase pregnancy rates compared with oral agents but carry substantially higher risks of multiple gestation and ovarian hyperstimulation syndrome, which limits their use as first-line agents. Eligible gonadotropin interventions in this review include recombinant FSH, urinary FSH, and human menopausal gonadotropin, both as standalone and in combination regimens.