Pergoveris

Pergoveris has a follicle-stimulating effect. This is a complex drug, which contains recombinant human FSH, as well as recombinant LH, which are produced by means of genetically engineered procedures.

The drug is used in the case of female hypogonadism of the hypogonadtropic type, in which there is a lack of FSH with LH. It is prescribed for IVF procedures, as well as ICSI or IVF + ICSI. The advantage of additional administration of r-LHH in case of insufficient effect when stimulating only r-FSHH was confirmed. Thanks to the addition of lutropin, the sensitivity of the ovaries to r-FSHch increases. [1]

Indications Pergoveris

It is used as part of reproductive programs under the following conditions:

• the presence of a suboptimal response (formation of 4-6 follicles) during previously performed stimulation using pure FSH ;
• the patient is over 35 years old and had a suboptimal response to stimulation previously;
• stimulation of follicular growth in the case of a pronounced lack of FSH with LH without the use of ART.

Release form

The release of the medication is realized in the form of a powder for the manufacture of a medicinal solution; the kit also contains a solvent.

Pharmacodynamics

FSH helps stimulate folliculogenesis, while LH regulates follicle formation as well as ovulation. Together with this, it contributes to the normal activity of the corpus luteum, required for conception and the development of pregnancy. [2]

LH also stimulates the production of androgens, which are further converted to estrogens, which are necessary to create the conditions required for conception. In addition, without estrogen, there is a violation of the processes of endometrial growth and the formation of the corpus luteum. [3]

Pharmacokinetics

Lutropin-α after subcutaneous injection undergoes distribution within the organs; the value of its bioavailability is about 60%.

Inside the body, it is observed for 5 hours. After a single use, the pharmacokinetic properties are similar to those determined with multiple administration; in this case, the substance accumulates only in minimal volumes. The use together with follitropin-α does not lead to the development of interaction.

After subcutaneous injection, the bioavailability level of follitropin-α is 70%. In the case of repeated administration, a 3-fold accumulation of the drug is observed. Css values reach within 3-4 days.

Dosing and administration

The therapy is performed exclusively under medical supervision. The medicine is administered only by the subcutaneous method. The powder must be diluted in a solvent, and then immediately use the entire portion.

Stimulation of the processes of formation and growth of follicles in the case of a pronounced lack of FSH with LH.

Therapy can be started on any day of the cycle. First, 1 bottle of the medicine is injected per day. The duration of the treatment course is selected personally, taking into account the size and growth of the follicle, determined during ultrasound, and in addition, taking into account the blood levels of estrogen. Within the limits of the 1st cycle of stimulation, it is allowed to prolong its period up to 5 weeks.

If an increase in the portion of r-FSHch is required, it is produced after 1-2 weeks, by 37.5-75 IU of follitropin-α. After receiving the required reaction, after 1-2 days, 5-10 thousand IU of hCG is applied. It is necessary to carry out intrauterine insemination or to have sexual intercourse on the day when hCG was introduced, or the next after it.

If the response to the stimulation being performed becomes excessive, therapy is suspended, postponing the use of hCG. It is necessary to resume treatment during the next cycle, but at the same time to introduce a lower dosage of r-FSHH.

Stimulation in case of suboptimal response during previous ART programs.

Therapy generally begins with a portion of 300 IU of standard r-FSHH, once a day for a period of 5-7 days. Further, from the 7th day, a transition is made to the introduction of 2 vials of the medication.

There are also alternative treatment regimens, selected by the doctor, taking into account the personal characteristics of the patient and the data obtained from previous stimulations. A maximum of 450 IU of r-FSHh is allowed per day.

The therapy is performed until the required level of follicular development is obtained, determined by ultrasound, as well as by the blood values of estrogens. After obtaining the indicated level, hCG is applied, which is required for the complete maturation of the follicles, and then the oocyte is removed.

In the case of a significant increase in the size of the ovaries, it is necessary to abandon the use of hCG and suspend therapy. It can be resumed during a new cycle, with the introduction of a reduced portion of drugs.

• Application for children

Pergoveris is not prescribed in pediatrics.

Use Pergoveris during pregnancy

It is forbidden to use the medication during pregnancy.

Contraindications

Among the contraindications:

• having an unknown nature of bleeding from the uterus;
• carcinoma of the breast, ovary or uterus;
• neoplasms in the pituitary gland or hypothalamus;
• volumetric cysts in the ovarian area;
• neoplasms affecting the uterus, or abnormalities of the genitals (congenital), in which pregnancy is impossible;
• ovarian insufficiency (primary type);
• GW period;
• severe intolerance to the medication.

Side effects Pergoveris

Among the often developing side symptoms: drowsiness or headaches, colic or pain in the abdominal area, vomiting, bloating, stool disturbances and nausea. In addition, OHSS of varying degrees of intensity, cysts in the ovarian region and signs in the area of the injection (swelling, bruising, redness and pain).

Among the manifestations that appear occasionally: exacerbation of asthma in persons with asthma, thromboembolism (in the case of severe OHSS) and apoplexy affecting the ovary. In addition, ectopic or multiple pregnancies and general allergy symptoms (rashes, facial swelling, urticaria, breathing problems, anaphylaxis, fever, generalized swelling and arthralgia).

Overdose

Intoxication with Pergoveris can lead to the development of OHSS.

Interactions with other drugs

It is forbidden to mix a medicine inside one syringe with other medicines (except follitropin-α).

Storage conditions

Pergoveris should be kept at temperatures not exceeding 25 ° C.

Shelf life

Pergoveris can be applied for a 36-month term from the date of release of the pharmaceutical product.

Analogs

An analogue of the medicine is the Menopur remedy.

Reviews

Pergoveris has received quite conflicting reviews. It is usually used for poor response to gonadotropins diagnosed during previous reproductive programs. There are comments from patients who consider Menopur to be a more effective remedy, with the use of which fewer follicles mature, but at the same time they are of a higher quality.