Gonal-f

Gonal-F (follicle-stimulating hormone, FSH) is a medicine containing the hormone follicle-stimulating hormone (FSH), which is used to stimulate ovulation in women who have difficulty conceiving. It can also be used in the treatment of male infertility caused by insufficient FSH secretion. Gonal-F is usually administered into the body by injection under the supervision of a physician.

Indications Gonal-f

1. For women:

   • Stimulation of ovulation in the treatment of infertility caused by anovulation (lack of ovulation) or insufficient ovulation.
   • Preparation for intracytoplasmic sperm injection (ICSI) or assisted embryo placement.

2. For men:

   • Treatment of infertility caused by insufficient release of follicle-stimulating hormone (FSH), if necessary to stimulate the process of spermatogenesis.

Release form

Gonal-F is usually available in powder or injection form.

Pharmacodynamics

1. Stimulation of ovarian function: Follicle-stimulating hormone stimulates the growth and development of follicles in the ovaries in women. The follicles contain eggs and, when optimally stimulated, can lead to ovulation.
2. Increased estrogen levels: FSH helps the eggs in the follicles produce estrogen, which helps prepare the body for possible conception and pregnancy.
3. Use in assisted reproduction procedures: Gonal-F is widely used in the ovulation stimulation program in assisted reproduction procedures, such as injection ovulation stimulation and controlled ovarian hyperstimulation (COHS) during ICSI (intracytoplasmic sperm injection) and ICSI procedures.
4. Correction of ovulation disorders: Gonal-F can also be used to correct ovulation disorders in women with inability to conceive caused by insufficient FSH secretion.

Pharmacokinetics

Follicle-stimulating hormone (FSH), represented by the drug Gonal-F, is usually injected into the body subcutaneously to stimulate the ovaries in women during infertility treatment. After administration, it is rapidly absorbed by tissues and slowly metabolized in the liver. Effects are usually seen within a few days after the injection. FSH acts on the ovaries, stimulating their growth and development of follicles. The level of the hormone in the blood is usually adjusted as needed, so pharmacokinetics may vary depending on the dosage and frequency of administration, as well as on the individual patient.

Dosing and administration

The method of use and dosage of Gonal-F (follitropin alfa) depend on the specific medical case and the recommendations of your doctor. Usually Gonal-F is administered intramuscularly or subcutaneously. Dosage may be individualized depending on a variety of factors, such as age, medical history, and response to treatment.

Use Gonal-f during pregnancy

1. Indications for use:

   • Gonal-F is not usually used after pregnancy. Its use is aimed at inducing ovulation and stimulating follicle development in women who have difficulty conceiving due to insufficient ovarian function.
   • The drug is usually not prescribed during pregnancy, since its purpose is to help pregnancy occur, not to maintain it.

2. Safety of use:

   • Data on the safety of follitropin alfa during pregnancy are limited. There are not enough studies to confirm its safety for use on the fetus during pregnancy.
   • Clinical guidelines generally recommend stopping the use of Gonal-F as soon as pregnancy is confirmed to avoid any potential risks to the developing baby.

3. Recommendations during pregnancy:

   • If pregnancy occurs as a result of treatment with Gonal-F, it is important to discuss the next steps and monitoring of the pregnancy with your doctor.
   • Doctors will usually closely monitor the pregnancy in women who have undergone fertility treatment to ensure that the fetus is developing normally.

Contraindications

1. Hypersensitivity: Patients with a known hypersensitivity or allergy to follicle-stimulating hormone or any of the components of the drug should avoid its use.
2. Organic diseases of the hypothalamus or pituitary gland: Gonal-F is contraindicated in patients with tumors of the hypothalamus or pituitary gland, as this may lead to increased tumor growth.
3. Hyperprolactinemia: In patients with hyperprolactinemia (increased levels of prolactin in the blood), Gonal-F may also be contraindicated.
4. Increased risk of multiple pregnancy: When using Gonal-F, the risk of multiple pregnancy (several embryos) increases, which can lead to complications during pregnancy and childbirth.
5. Ovarian insufficiency: In women with complete ovarian failure, Gonal-F may not have the desired effect or may be contraindicated.
6. Severe kidney or liver disease: Gonal-F may affect kidney and liver function, so its use may be contraindicated in patients with severe diseases of these organs.
7. Pregnancy: Gonal-F should not be used during pregnancy.

Side effects Gonal-f

1. Ovarian hyperstimulation: In some cases, taking Gonal-F can lead to the development of ovarian hyperstimulation, which is characterized by an increase in ovarian size, fluid retention and potentially serious complications. This can be especially problematic when used in the treatment of infertility.
2. Multiple pregnancies: Use of Gonal-F may increase the likelihood of a multiple pregnancy (pregnancy with two or more fetuses).
3. Injection site reactions: Local reactions such as redness, pain or swelling at the injection site may also occur in some patients.
4. Other possible side effects: Other side effects may also occur, such as headache, nausea, bloating, and irritability.

Overdose

1. Ovarian Hyperstimulation (OSH): An overdose of Gonal-F may result in excessive stimulation of the ovaries, which can cause OHS. This condition is characterized by an increase in the size of the ovaries, fluid accumulation in the abdominal cavity (ascites) and the possible development of intra-abdominal bleeding (hemoperitoneum).
2. Increased risk of multiple pregnancies: Intensive ovarian stimulation may also increase the risk of multiple pregnancies associated with assisted reproduction procedures such as injectable ovulation stimulation and CGOS.
3. Potential Other Complications: Overdose may also lead to other unwanted effects associated with hormonal instability and overstimulation of the ovaries, such as breast tenderness, menstrual irregularities, headaches, nausea and vomiting.

Interactions with other drugs

Interactions of Gonal-F with other drugs are usually minimal due to its specific mechanism of action. However, if you are using other medications at the same time, you should discuss this with your doctor to ensure there are no potential unwanted interactions. Particular attention should be paid to drugs that also affect the reproductive system or may affect the body's endocrine functions.

Storage conditions

Gonal-F is usually stored in the refrigerator at a temperature of 2°C to 8°C. The drug must be protected from freezing and light. It is important to follow the manufacturer's instructions and not use the drug after the expiration date. If you need to store Gonal-F during transportation or travel, make sure it is stored in a cool bag or container with refrigerant to maintain the correct temperature.