What are Gonadotropins?

Gonadotropins are injectable fertility medicines that boost or replace the hormones made in the pituitary gland that stimulate egg growth in the ovaries.

How do Gonadotropins work?

Normally, each month, your pituitary gland makes enough Gonadotropins to allow one egg to grow to full or "dominant" size. By injecting Gonadotropins we are often able to stimulate one or more eggs to grow.

Who may need Gonadotropins?

• Women who do not have regular monthly cycles
• Women who have tried clomiphene but either did not ovulate or ovulated but did not get pregnant
• Older reproductive-aged women (age 35 and older) with normal blood FSH and estradiol results who, monthly, have fewer "good eggs" left to ovulate
• Women (under 35 years old) with unexplained infertility

Who is not likely to become pregnant using Gonadotropins?

• Women (40 years old or older) with ovulatory cycles have the same chance of becoming pregnant whether medication is used or not
• Women with elevated FSH or estradiol levels have low monthly chances with any fertility medication. Gonadotropins are mainly FSH (follicle stimulating hormones) which makes eggs grow. If your FSH is already elevated, adding more FSH will not increase the possibility of pregnancy. Similarly, Gonadotropins are designed to increase estradiol. If your estradiol is already elevated, Gonadotropins will not help you
• Couples with male factor infertility
• Women with tubal or ovarian scar tissue

What is necessary before being considered for Gonadotropins therapy?

• Age less than 44 and non-smoking
• Normal semen analysis
• If any tubal or pelvic problems are present, they have been corrected
• The woman is able to follow instructions for daily self-injection and is able to come for frequent clinic visits, on short notice, to monitor egg growth.
• The woman has participated in a training class and has demonstrated good ability to correctly prepare medication and perform self-injection

How is Gonadotropins therapy performed?

After training class has taken place for the typical therapy cycle, you call the fertility on the first day of your period. Within the first few days of your period you will be scheduled for a "baseline" endovaginal ultrasound to make sure you do not have any leftover cysts from a prior menstrual cycle. If the ovaries and uterus are seen to be normal, you will be given a prescription for medication and a schedule of when to take your medication, what dose to take, and when you should return for blood tests or ultrasound monitoring. At that time, your ovarian response will be evaluated, your dose may be changed, and you will be told when to return for further blood tests or ultrasound monitoring. This process of taking daily injections with frequent monitoring by blood tests and ultrasounds continues until the desired number of eggs have grown to the right size. At that time you will stop the stimulation shots and be instructed to take another shot (hCG) to begin the ovulation.

How many eggs do I need?

The number of eggs we want to grow depends on each patient’s condition. For young women without normal monthly cycles, one egg may be the goal. For older women with unexplained infertility, the goal may be as many as 5 or 6.

How many cycles will I get?

Again, the number depends upon each patient’s condition. Most success occurs in the first cycle. After that chances are less. As long as there is good growth of eggs at a normal dose of medication, and other conditions mentioned above are satisfied, for example, normal semen analysis, and normal or corrected pelvic conditions, we expect that 3 cycles of Gonadotropins is a good trial.

What are the side effects of Gonadotropins?

• Multiple pregnancy, twins or more, may occur in approximately 20% of cycles where pregnancy occurs
• Abdominal pain due to enlarged ovaries occurs in 20% of cycles
• Severe, but temporary, bloating following ovulation occurs in 5% of cycles
• Hospitalization for a few days may be required for approximately 1% of women due to pain, severe bloating, nausea, inability to eat, drink and urinate
• Currently available data does not show an increased risk of either birth defects in children born after Gonadotropins therapy or an increased risk of cancer. Women with infertility have an increased risk of most female cancers whether they do or do not take injectable fertility medication.