Spiroindoline derivatives, processes for their preparation and pharmaceutical compositions thereof, their use for the treatment of diseases, and their use for the manufacture of medicaments for the treatment of diseases, especially sex-
hormone-related diseases in both men and women, in particularly those selected from the group of 
endometriosis, 
uterine leiomyoma (fibroids), polycystic ovarian 
disease, menorrhagia, dysmenorrhea, 
hirsutism, 
precocious puberty, gonadal 
steroid-dependent neoplasia such as cancers of the 
prostate, breast and 
ovary, gonadotrope pituitary adenomas, 
sleep apnea, 
irritable bowel syndrome, premenstrual syndrome, benign prostatic hypertrophy, contraception, 
infertility and assisted reproductive therapy such as 
in vitro fertilization. The present application relates in particular to spiroindoline derivatives as 
gonadotropin-releasing 
hormone (GnRH) 
receptor antagonists.