Recombinant FSH (hFSH)

Classification

Human recombinant follicle stimulating hormone (FSH)

Brand Names

Follistim® (mfg. Organon), Puregon® (mfg. Organon), Gonal-F® (mfg. Serono)

Form

Subcutaneous or intramuscular injection

Indications

Demonstrated ovulatory dysfunction with:

  • No current pregnancy
  • No evidence of primary ovarian failure
  • No uncontrolled thyroid or adrenal dysfunction
  • No ovarian cysts (except in case of PCOS)
  • Used in conjunction with hCG

Used for

In women, inducing ovarian follicular growth and maturation. May be particularly useful for women with PCOS (polycystic ovarian syndrome).

How does it work?

Possesses hormonal activities of follicle stimulating hormone (FSH).

Suggested Evaluations

Pre-RX

  • thyroid disease
  • ovarian enlargement or cyst formation
  • uterine fibroid tumors
  • undiagnosed unusual vaginal bleeding
  • estrogen levels
  • primary pituitary or ovarian failure or enlargement
  • evidence of prostate cancer in men
  • testicular failure
  • renal and hepatic functions

During RX

  • mid-cycle urine LH test (OPK)
  • estrogen levels
  • progesterone levels
  • mid-cycle ultrasound to detect follicle development

Usual Dosage

Dosage must be carefully determined for each patient, and may be changed during treatment cycle.

During a fertility treatment cycle in women, 75 units to 600 units injected once daily for 6 to ten days, beginning on CD (cycle day) 2 or 3.

Instructions

Keep refrigerated. Maintain BBT chart or other recommended cycle charting methods throughout treatment cycle. If self-injecting and miss a dose, take as soon as remember, but not as late as the following day. Do not double doses. Use prepared/mixed solution immediately and discard any unused medication.

Common side effects

  • Injection site pain
  • Lower abdomen tenderness
  • Fluid retention
  • Headache
  • Emotional irritability
  • Breast discomfort
  • Fatigue
  • Multiple births

Side effects to report to your doctor

  • Severe pain or swelling in lower abdomen or extremities
  • Shortness of breath
  • Vomiting or diarrhea

Precautions

  • Pregnancy Category X: May cause birth defects if used during pregnancy.
  • Exercise caution if patient is breastfeeding.
  • May result in ovarian hyperstimulation.
  • May result in multiple births.

Drug interactions or incompatibility

Herbal preparations using blue or black cohosh.

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