Prostaglandins in human reproduction

Abstract

Prostaglandins are biologically-active, lipid-soluble, unsaturated fatty acids which are present in all organs of the reproductive system and their secretions. Von Euler (1936) established that the pharmacologically-active principle in seminal fluid was a new substance and called it prostaglandin, in the belief that it was secreted by the prostate gland. Subsequently it was shown that seminal fluid prostaglandins originate from the seminal vesicles. Human semen contains a number of related biologically-active hydroxy fatty acids, all now known as prostaglandins. The involvement of prostaglandins in various physiological and pharmacological processes associated with human reproduction is listed by male (fertility) and female (fertility, pregnancy, lactation, umbilical and fetal circulation, synthesis inhibitors, involvement in pathological situation). Clinical applications of prostaglandins are based on either mimicking these effects by the use of exogenous prostaglandins or in some situations by preventing their synthesis; the following applications for the female are discussed successively - contraception, menstrual regulation/termination of very earl pregnancy, termination of 1st trimester pregnancy (7-12 wk), preoperative cervical dilation, termination of 2nd trimester pregnancy (death in utero, molar and anencephalic pregnancies), induction of lbor at term, prevention of postpartum hemorrhage (and other hemorrhage).