Examples
|
| human chorionic gonadotropin (hCG) | Ovidrel, Pregnyl |
| human menopausal gonadotropin (hMG) | Bravelle, Menopur, Repronex |
| recombinant human follicle-stimulating hormone (rFSH) | Follistim, Gonal-F |
How It Works
Gonadotropin fertility medicines contain follicle-stimulating hormone (FSH), luteinizing hormone (LH), or both. These hormones play a central role in egg production.
In women.
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.
Why It Is Used
Gonadotropins are given by
injection to help the body make the hormones needed for egg or sperm
production.
In women. Gonadotropins may be
used:
- To stimulate ovulation related to low natural
gonadotropin or
estrogen levels. (This is most commonly seen in women
with excessive exercise or eating disorders.)
- When clomiphene
alone or clomiphene combined with another medicine has been ineffective for
correcting irregular or no ovulation caused by
polycystic ovary syndrome (PCOS).
- For
developing multiple egg follicles on the ovaries. Multiple eggs are harvested
and used in
assisted reproductive techniques such as in vitro
fertilization or gamete intrafallopian transfer.
- In combination
with
intrauterine insemination for couples with unexplained
infertility when clomiphene has not worked.
In men. Gonadotropin therapy can
treat low sperm counts caused by low levels of natural gonadotropins.
How Well It Works
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 60 out of 100 women failing to ovulate. But of
those pregnancies, up to 35% end in
miscarriage.1
Side Effects
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:
- Usually the benefits of the medicine are more important than any minor side effects.
- Side effects may go away after you take the medicine for a while.
- If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.
Call 911 or other emergency services right away if you have:
- Trouble breathing.
- Swelling of your face, lips, tongue, or throat.
For women
Call your doctor if you have:
- Hives.
- Bloating.
- Pain, swelling or irritation at the injection site.
- Rash at the injection site or on your body.
- Stomach or pelvic pain.
Common side effects of this medicine include:
- Coughing.
- Headache.
- Mild nausea.
- Sneezing.
- Sore throat.
- Stuffy or runny nose.
For men
Call your doctor if you have:
- Hives.
- Shortness of breath.
- Dizziness.
- Fainting.
- Headache.
- Loss of appetite.
- Frequent nosebleeds.
Common side effects of this medicine include:
- Breast enlargement (temporary).
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
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
complications.
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
population.
Taking medicine
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.
Advice for women
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.
Checkups
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)(What is a PDF document?) to help you understand this medication.
References
Citations
- Lobo RA (2007). Infertility: Etiology, diagnostic
evaluation, management, prognosis. In VL Katz et al., eds., Comprehensive Gynecology, 5th ed., pp. 1001–1037.
Philadelphia: Mosby.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology |
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| Last Revised | May 14, 2012 |
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