Hormonal fertility treatment and the Prohibited List of the World Anti-Doping Agency (WADA)

Many active ingredients used for hormonal fertility treatment are part of the so-called Prohibited List that applies in sports. In women, gonadotropin-releasing hormone (GnRH) receptor agonists or antagonists, gonadotropins, antiestrogens and/or aromatase inhibitors are used to stimulate ovulation. After the follicle puncture and into pregnancy, gestagens and human chorionic gonadotropin support the maintenance of the pregnancy. In cases of male infertility, aromatase inhibitors and antiestrogens used off-label can improve sperm production and mobility. Of course, competitive athletes should not be denied the possibility of assisted reproductive treatment per se. This article explains the current anti-doping regulations, the process for approval of the use of prohibited substances by athletes and contains tips on how treating physicians can provide support, so that hormonal fertility treatment can be carried out in accordance with the anti-doping rules.