Fertility Drugs

Fertility Drugs | Typical Cycle | Success/Risk

Gonadotropins are injectible hormonal agents used to induce ovulation. Whereas Pergonal® and Repronex® are combinations of follicle stimulating hormone (FSH) and luteinizing hormone (LH), Bravelle®, Follistim® and Gonal-F® are preparations of highly purified FSH. The FSH/LH preparations are extracted from the urine of postmenopausal women; the highly purified FSH preparations are genetically engineered human hormones produced by ovarian cells in sterile tissue culture. All of these purified preparations are powerful hormonal agents which act directly upon the ovary and which stimulate the growth and maturation of egg cells. During treatment with gonadotropins the patient is monitored carefully with blood estrogen testing and ultrasonography.

These medications are supplied in ampules or vials in powder form in a dosage of either 75 IU or 150 IU. Follistim® is available in a 300 IU or 600 IU aqueous solution. A specially-designed injection pen is provided for self-administering the Follistim injections. Gonal-F® is also available in a 1400 IU multidose vial. An ampule of liquid (diluent) is given to reconstitute the powder medication. Gonadotropins are relatively expensive medications and may not be carried by many pharmacies.

Gonadotropins will be administered per the recommendations of the prescribing physician. These medications can be given either subcutaneously or intramuscularly.

The following are frequent symptoms associated with gonadotropins and are generally not serious: breast tenderness and fullness, fluid retention, mood swings, abdominal bloating, abdominal discomfort, tenderness, redness and/or discomfort at the injection site.

If a patient develops any of the following symptoms, it is important to contact the physician as soon as possible: significant abdominal pain, dizziness, or weakness. These symptoms could indicate ovarian hyperstimulation syndrome (OHSS), a syndrome in which the ovaries are enlarged and multicystic. Further possible symptoms of OHSS include nausea, vomiting, and abdominal distention. This syndrome is seen in approximately 3-5% of patients using gonadotropin medications.

There is also the possibility of insufficient or excessive response to these medications, leading to too few or too many follicles, respectively. Such response could require cancellation of the ovulation induction cycle (approximately 10-15% of cycles).

Gonadotropin medications are expensive, generally costing between $45 and $60 per ampule. Some insurance carriers may cover part or all of these medication costs.