Indications
Follicle Stimulating Hormone (FSH) is a fertility medicine. In women it is used to stimulate the ovaries to develop eggs, for example in women who do not ovulate (including some with polycystic ovary syndrome) and in assisted reproduction such as IVF or IUI. In men it may be used with hCG to stimulate sperm production in some types of hormone deficiency. It is prescribed and monitored only by a fertility specialist.
How It Works
FSH is a natural hormone made by the pituitary gland. In women it makes the follicles in the ovary (small fluid sacs that contain eggs) grow and mature. In men it acts on the testes to support sperm production. The medicine provides extra FSH to boost these processes.
Dosage and Administration
It is given as an injection under the skin or into the muscle, usually once a day, as prescribed by the fertility specialist. The starting dose and length of treatment depend on the person’s condition and response, checked by ultrasound scans and blood hormone tests, and are adjusted by the doctor. The first injection is usually given in the clinic and patients may then be trained to inject themselves. Do not change the dose yourself.
Interactions
- Used together with other fertility medicines such as Clomiphene, GnRH agonists or antagonists and hCG; these combinations are planned by the specialist and may change the dose needed.
- Tell the doctor about all other medicines and supplements.
Contraindications
- Allergy to FSH or any ingredient.
- Tumours of the ovary, breast, uterus, pituitary gland or hypothalamus, or testicular tumours in men.
- Enlarged ovaries or ovarian cysts not due to polycystic ovary syndrome.
- Unexplained vaginal bleeding.
- Primary ovarian or testicular failure, or conditions where pregnancy is not possible (such as uterine malformations).
- Pregnancy and breastfeeding.
Side Effects
Common effects include pain, redness or bruising at the injection site, headache, bloating, mild stomach pain and nausea. Ovarian hyperstimulation syndrome (OHSS), where the ovaries over-respond, can occur. Multiple pregnancy (twins or more) and ectopic pregnancy are more likely with fertility treatment.
Get urgent medical help if you have severe stomach pain or swelling, rapid weight gain, very little urine, nausea and vomiting, shortness of breath (possible severe OHSS), pain or swelling in a leg, chest pain, or signs of a severe allergic reaction.
Pregnancy and Lactation
FSH is not used once pregnancy has started and should not be used during breastfeeding.
Precautions and Warnings
Treatment requires close monitoring with ultrasound and blood tests to reduce the risk of OHSS and multiple pregnancy. Thyroid, adrenal and pituitary problems should be checked and treated before starting. Women with risk factors for blood clots need extra care. Use the pen or syringe exactly as taught and never share needles.
Overdose
Too much FSH can cause ovarian hyperstimulation. Contact the fertility clinic immediately if a wrong dose is given.
Therapeutic Class
Gonadotrophin; fertility hormone.
Storage
Store in a refrigerator at 2 to 8°C. Do not freeze. Some pens may be kept at room temperature for a limited time after opening, as stated on the pack. Keep out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.