FEMALE INFERTILITY : IN MENSTRUATING PATIENTS TREATMENT SHOULD BE STARTED WITHIN THE FIRST 7 DAYS OF THE MENSTRUAL CYCLE.
TREATMENT IS USUALLY BEGUN WITH 75 TO 150 UNITS DAILY BY SUBCUTANEOUS OR INTRAMUSCULAR INJECTION FOR 7 OR 14 DAYS; IF THERE IS NO RESPONSE, DOSAGE IS INCREASED AT 7- OR 14-DAY INTERVALS UNTIL AN ADEQUATE BUT NOT EXCESSIVE RESPONSE IS ACHIEVED.
TREATMENT IS THEN STOPPED AND FOLLOWED AFTER 1 OR 2 DAYS BY A SINGLE DOSE OF CHORIONIC GONADOTROPHIN 5000 TO 10 000 UNITS TO INDUCE OVULATION. A DAILY DOSE OF 225 UNITS IS THE USUAL MAXIMUM, AND THAT IF A PATIENT FAILS TO RESPOND ADEQUATELY AFTER 4 WEEKS OF TREATMENT THAT CYCLE SHOULD BE ABANDONED AND THE PATIENT SHOULD SUBSEQUENTLY BEGIN THE NEXT CYCLE AT A HIGHER STARTING DOSE.
FOLLITROPINS ARE ALSO USED AS PART OF IVF OR OTHER ASSISTED REPRODUCTIVE TECHNOLOGIES.
FOR THIS PURPOSE DOSES OF 150 TO 225 UNITS DAILY ARE GENERALLY GIVEN, FOR AT LEAST 4 DAYS, COMMENCING ON THE SECOND OR THIRD DAY OF THE MENSTRUAL CYCLE. THEREAFTER THE DOSE MAY BE ADJUSTED INDIVIDUALLY BASED ON OVARIAN RESPONSE TO A USUAL MAXIMUM OF ABOUT 450 UNITS; ADEQUATE FOLLICULAR DEVELOPMENT GENERALLY OCCURS WITHIN ABOUT 5 TO 10 DAYS OF TREATMENT.
PITUITARY DOWNREGULATION WITH A GONADORELIN ANALOGUE MAY BE USED WITH FOLLITROPIN THERAPY, IN WHICH CASE THE GONADORELIN ANALOGUE IS GENERALLY BEGUN ABOUT 2 WEEKS BEFORE FOLLITROPIN, AND THE 2 ARE THEN CONTINUED TOGETHER UNTIL FOLLICULAR DEVELOPMENT IS ADEQUATE.
A SINGLE DOSE OF UP TO 10 000 UNITS OF CHORIONIC GONADOTROPHIN IS THEN GIVEN TO INDUCE FINAL FOLLICULAR MATURATION AND OOCYTE RETRIEVAL PERFORMED ABOUT 35 HOURS LATER.
MALE INFERTILITY : CAUSED BY HYPOGONADOTROPHIC HYPOGONADISM. BEFORE STARTING FOLLITROPIN THERAPY, CHORIONIC GONADOTROPHIN IS GIVEN TO RAISE SERUM TESTOSTERONE CONCENTRATIONS TO THE NORMAL RANGE, WHICH MAY TAKE 3 TO 6 MONTHS. A DOSE OF 150 UNITS SUBCUTANEOUSLY THREE TIMES WEEKLY IS THEN USED, WITH CONTINUED CHORIONIC GONADOTROPHIN; DOSES OF FOLLITROPIN ALFA UP TO 300 UNITS THREE TIMES WEEKLY MAY BE REQUIRED. TREATMENT IS CONTINUED FOR AT LEAST 4 MONTHS, AND MORE THAN 18 MONTHS OF TREATMENT MAY BE NEEDED. A DOSE OF FOLLITROPIN BETA 75 UNITS DAILY OR TWO OR THREE TIMES WEEKLY, BY SUBCUTANEOUS OR INTRAMUSCULAR INJECTION, HAS BEEN USED SIMILARLY.