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Gonadotropin fertility medicines contain follicle-stimulating hormone (FSH), luteinizing hormone (LH), or both. These hormones play a central role in egg production.
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are needed
for egg production (ovulation). Early in the
menstrual cycle, a woman with low hormone levels who
is not ovulating can have daily human menopausal gonadotropin (hMG) or
recombinant human FSH (rFSH) injections for an average of 12 days. If this
helps develop mature follicles, the ovary is ready to ovulate. One dose of
human chorionic gonadotropin (hCG) is then used to stimulate ovulation.
In men with low testosterone and FSH. LH
stimulates the production of
testosterone, and FSH promotes the formation of sperm.
If a semen analysis, LH testing, and FSH testing suggest that abnormal hormone
levels are preventing sperm production, these gonadotropins may be prescribed
together to promote sperm formation. The man gets an hCG injection 3 times
weekly until blood testosterone level is within the normal range (this may take
4 to 6 months). Treatment continues with injections of hCG 2 times a week and
hMG or FSH 3 times a week until the sperm count rises to normal levels.
Gonadotropins are given by
injection to help the body make the hormones needed for egg or sperm
In women. Gonadotropins may be
In men. Gonadotropin therapy can
treat low sperm counts caused by low levels of natural gonadotropins.
The combination human menopausal
gonadotropin (hMG)/human chorionic gonadotropin (hCG) or recombinant human
follicle-stimulating hormone (rFSH)/hCG treatment can consistently stimulate
ovulation. It results in pregnancy in 30 to 60 out of 100 women who fail to ovulate. But of
those pregnancies, up to 35% end in
All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.
Here are some important things to think about:
Call 911 or other emergency services right away if you have:
Call your doctor if you have:
Common side effects of this medicine include:
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
During gonadotropin treatment,
frequent monitoring of egg follicle development is needed. This may be done with
ultrasound and blood tests. Without careful
monitoring, the ovaries may become hyperstimulated. Ovarian hyperstimulation syndrome (OHSS) can be a very serious condition. It usually goes away by itself in 2
to 4 weeks. But a woman may need bed rest or hospitalization and intravenous
fluid therapy. Or she may need a procedure to remove fluid from the abdomen.
Gonadotropins should only be used by doctors who are specially trained in
infertility and who are familiar with the management of possible
Ovarian stimulation increases the likelihood of
multiple pregnancy (twins, triplets, or more).
Up to 35% of women who become pregnant after
hMG/hCG or rFSH/hCG therapy have a miscarriage.1 This
is higher than the risk of miscarriage in the general
Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.
There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.
After you know you are pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant or trying to get pregnant.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Complete the new medication information form (PDF)new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Lobo RA (2012). Infertility: Etiology, diagnostic evaluation, management, prognosis. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 869–895. Philadelphia: Mosby.
November 14, 2013
Kathleen Romito, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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