Gonal-f

Gonal-F (follicle-stimulating hormone, FSH) is a medication containing the hormone follicle-stimulating hormone (FSH) that is used to stimulate ovulation in women who have difficulty conceiving. It can also be used to treat male infertility caused by insufficient FSH secretion. Gonal-F is usually given as an injection under the supervision of a doctor.

Indications Gonal-f

1. For women:

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

2. For men:

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

Release form

Gonal-F is usually available as a powder or solution for injection.

Pharmacodynamics

1. Stimulation of ovarian function: Follicle-stimulating hormone stimulates the growth and development of follicles in the ovaries of women. Follicles contain eggs and, if 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 infertility caused by insufficient FSH secretion.

Pharmacokinetics

Follicle-stimulating hormone (FSH), represented by Gonal-F, is usually administered subcutaneously to stimulate the ovaries in women undergoing fertility treatment. After administration, it is rapidly absorbed by tissues and slowly metabolized in the liver. The effects are usually observed within a few days after injection. FSH acts on the ovaries, stimulating their growth and follicle development. The hormone level in the blood is usually adjusted as needed, so the pharmacokinetics may vary depending on the dosage and frequency of administration, as well as individual patient characteristics.

Dosing and administration

The method of administration and dosage of Gonal-F (follitropin alfa) depend on your specific medical situation and your doctor’s recommendations. Gonal-F is usually administered intramuscularly or subcutaneously. The dosage can be individualized depending on many 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 follicular development in women who have difficulty conceiving due to insufficient ovarian function.
   • The drug is not usually prescribed during pregnancy, since its purpose is to help achieve pregnancy, not to maintain it.

2. Safety of use:

   • There is limited safety data on the use of follitropin alfa during pregnancy. There are not enough studies to confirm the safety of its use for 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 next steps and monitoring of the pregnancy with your doctor.
   • Doctors will usually closely monitor the pregnancy of women who have undergone fertility treatment to make sure the fetus is developing normally.

Contraindications

1. Hypersensitivity: Patients with 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 it may lead to increased tumor growth.
3. Hyperprolactinemia: In patients with hyperprolactinemia (elevated levels of prolactin in the blood), Gonal-F may also be contraindicated.
4. Increased risk of multiple pregnancies: When using Gonal-F, the risk of multiple pregnancies (several embryos) increases, which can lead to complications during pregnancy and childbirth.
5. Ovarian insufficiency: In women with complete ovarian insufficiency, 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, Gonal-F may cause ovarian hyperstimulation, which is characterized by enlarged ovaries, fluid retention, and potentially serious complications. This may be particularly problematic when used in the treatment of infertility.
2. Multiple pregnancies: The use of Gonal-F may increase the chance of 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 such as headache, nausea, bloating and irritability are also possible.

Overdose

1. Ovarian hyperstimulation syndrome (OHSS): Overdose of Gonal-F may result in excessive stimulation of the ovaries, which may cause OHSS. This condition is characterized by enlargement of the ovaries, fluid accumulation in the abdominal cavity (ascites), and possibly the development of intra-abdominal bleeding (hemoperitoneum).
2. Increased risk of multiple pregnancy: Intensive ovarian stimulation may also increase the risk of multiple pregnancy, which is associated with assisted reproduction procedures such as injection ovulation stimulation and CGDS.
3. Potential other complications: Overdose may also lead to other unwanted effects related to 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, when using other drugs at the same time, it is necessary to discuss this with your doctor to ensure that there are no potential unwanted interactions. Particular attention should be paid to drugs that also affect the reproductive system or may affect the endocrine functions of the body.

Storage conditions

Gonal-F is usually stored in the refrigerator at a temperature of 2°C to 8°C. The drug should 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 cooler bag or container with refrigerant to maintain the correct temperature.