Luteinizing Hormone (DB14741): A Comprehensive Endocrinological and Pharmacological Review

Executive Summary

Luteinizing Hormone (LH) is a pivotal gonadotropin hormone, classified as a biotech drug (DrugBank ID: DB14741, CAS: 9002-67-9), that is indispensable for mammalian reproduction.[1] Secreted by the anterior pituitary gland, it executes a dual function critical for sexual development and fertility. In males, LH stimulates the Leydig cells of the testes to produce testosterone, the principal androgen essential for spermatogenesis and the maintenance of male characteristics. In females, it orchestrates the menstrual cycle, culminating in an acute surge that triggers ovulation and subsequently promotes the corpus luteum's production of progesterone to support potential pregnancy.[3]

Therapeutically, LH is available in two main classes: urinary-derived menotropins, which contain a mixture of LH and follicle-stimulating hormone (FSH), and the highly purified recombinant human LH (r-hLH), lutropin alfa, which offers superior purity and batch-to-batch consistency.[6] Its primary clinical application is in treating infertility, particularly in the niche population of women with hypogonadotropic hypogonadism who have a profound LH deficiency.[6] While clinical data comparing recombinant and urinary-derived formulations show nuanced results depending on the patient population, economic analyses suggest that the higher efficacy of recombinant LH can lead to greater cost-effectiveness by reducing the total cost per live birth.[10] The safety profile of LH therapy is well-characterized, with Ovarian Hyperstimulation Syndrome (OHSS) being the most significant iatrogenic risk, necessitating careful patient monitoring and management.[13] The therapeutic landscape for targeting the LH pathway continues to expand beyond reproduction, with LH-releasing hormone (LHRH) analogues established as a cornerstone of androgen deprivation therapy in oncology and