FSH is produced by the pituitary gland following stimulation with gonadotropin releasing hormone (GnRH), which is released by the hypothalamus.  When FSH is injected, it stimulates the ovaries directly causing the development of numerous eggs.  FSH is the most effective treatment for those women with irregular cycles who need a fertility drug. 

When is FSH Used?

FSH is also used in virtually all assisted reproductive technology (ART) procedures because numerous eggs are needed for the various steps in the IVF process.  Also, there must be enough eggs to insure the formation of sufficient, viable, embryos for transfer.

These medications either have all FSH or a combination of FSH and LH.  Follistim and Gonal-F are made in the lab and are pure preparations of FSH.  The others are human derived products and contain a combination of both FSH and LH.  Some patients have low levels of LH found on day 3-4 testing and need a preparation with LH, while others do well with a pure FSH product.  When LH is needed, the doctor may use an FSH/LH product or a combination of 2 different preparations. 

Also, women on either Lupron or Synarel have low levels of LH and need a combination regimen.  In all cases, drug protocols are designed for each patient based on LH levels, previous history, and patient’s diagnosis.  Furthermore, some fertility specialists have a preference based on previous success.

How are Gonal-F, Follistim, Repronex, Bravelle, and Menopur Administered?

All of these preparations, as well as the hCG “trigger” shot, can be given by subcutaneous injection, thereby increasing patient comfort and ease.  Both Follistim and Gonal-F are available in a convenient “pen injector”.  Side effects of these products include ovarian enlargement, hyperstimulation syndrome, multiple births, and others. See each manufacturer’s Web site for a complete discussion of side effects.

Throughout the stimulation cycle the dosage of FSH is adjusted based upon each patient’s individual response.  Patients must come to our fertility clinic in Greensboro, NC several times during the stimulation cycle for estradiol blood level measurements and transvaginal ultrasound examinations. 

Ultrasound allows Dr. Deaton to directly view the number and development of follicles.  Dosages are adjusted based upon each patient’s response.

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