Female infertility, Male infertility, In vitro fertilisation procedures or other assisted conception techniques

Parenteral Female infertility Adult: 75-150 units of FSH daily via IM or SC inj; adjust gradually until adequate response is achieved. Treatment is stopped and followed after 1 or 2 days by single dose of chorionic gonadotrophin 5000-10,000 units. In menstruating patients, start within the 1st 7 days of menstrual cycle. Alternatively, 3 equal doses IM or SC, each providing 225-375 units of FSH on alternate days followed by chorionic gonadotrophin 1 wk after the 1st dose. Stop treatment if no response is seen in 3 wk. Course may be repeated twice more, if necessary. Male infertility Adult: Stimulate spermatogenesis with chorionic gonadotrophin, then with human menopausal gonadotrophin in a dose of 75 or 150 units of FSH 2 or 3 times wkly by IM or SC. Treatment should be continued for at least 3 or 4 mth. In vitro fertilisation procedures or other assisted conception techniques Adult: (In conjunction with chorionic gonadotrophin and sometimes clomiphene citrate or a gonadorelin analogue.) 75-300 units of FSH daily via IM or SC inj usually beginning on the 2nd or 3rd day of menstrual cycle. Combined regimen: 100 mg clomiphene citrate on days 2-6, with human menopausal gonadotrophins beginning on day 5 in a dose providing 150-225 units of FSH daily. Continue until an adequate response is obtained; final inj of human menopausal gonadotrophins is followed 1-2 days later with up to 10,000 units of chorionic gonadotrophin.

Ovarian cysts or enlargement not caused by polycystic ovarian syndrome; tumors of breast, uterus, ovaries, testes or prostate; vaginal bleeding of unknown cause; pregnancy and lactation.

Human menopausal gonadotrophins possess both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activities.

Hyperprolactinemia or tumors of the pituitary or hypothalamus. Ovarian enlargement at risk of rupture, care in pelvic examinations. Risk of multiple births.

Ovarian hyperstimulation, risk of multiple pregnancy and miscarriage, hypersensitivity and local reactions at Inj site, nausea, vomiting, joint pain, fever. In men, gynecomastia, acne, weight gain. Potentially Fatal: Rupture of ovarian cysts and intraperitoneal haemorrhage.

Drugs with luteinising hormone activity may increase risk of ovarian hyperstimulation syndrome.