FSH & HMG Injectable Drugs

What are Injectable Drugs?

FSH (Gonal F, Follistim or Bravelle) and HMG (Pergonal or ReproNex) are medications which are given by injection to stimulate the ovaries to develop multiple follicles (which contain eggs). These medications are given when the development of follicles is not occurring naturally or when the well timed production of multiple eggs is desired. They can also be used in women who do ovulate to increase their chances of implantation; when Clomid has failed; or for IVF.

Monitoring Your Safe Response

Because women respond to these fertility medications at different rates, careful monitoring with vaginal ultrasound and blood estrogen testing is critical to achieve proper, individualized dosage. The purpose of this monitoring is to assure that the correct amount of medication is given and that ovulation is triggered when eggs are mature.

A baseline ultrasound scan is done at the beginning of your cycle (day 1, 2, or 3) prior to beginning the medications to ensure that the ovaries appear normal, especially if the drugs were used in the previous cycle. After several days of injections, additional ultrasound testing is performed, until the follicles are measured to be a precise size and the corresponding level of estrogen in your blood reaches a particular level. At this point, the eggs are felt to be mature, or ready, and we then instruct that you take the HCG shot. Ovulation then begins approximately 36 hours later, and intercourse or IUI is timed accordingly.

Side Effects

Some side effects which may be observed during a medication cycle are breast tenderness, mood swings, bloating, tiredness, and pelvic discomfort. Many women form temporary cysts on their ovaries after ovulation. These cysts do not usually cause any problems other than some pelvic fullness, and they always eventually go away. Sometimes, however, these cysts will grow to considerable size and may cause significant abdominal bloating or pain. The resulting condition is referred to as hyperstimulation. Please call us if you have any problems during this time and particularly if you experience dizziness, decreased urination, shortness of breath, or a weight gain of more than 5 pounds.

Risks

These drugs are associated with an increased risk of multiple births. This incidence of multiple pregnancies is approximately 25%, usually in the form of twins. Less than 5% of the total pregnancies result in triplets, and less than 1 % are higher-order. There is no evidence that miscarriages or birth defects are more common with these drugs. There is also no evidence that these medications cause the development of earlier menopause or any other maternal complication such as the later development of ovarian cancer. Ovarian hyperstimulation syndrome is a potential serious complication, which will be described to you in detail in your injection class, videotape, and consent forms, which we require you to view before you get started.

Consent Forms

CT Fertility uses this consent form for Superovulation Therapy.