AlternativeGonal-f / Puregon
Recombinant FSH (follitropin α/β)
Gonadotropin — recombinant follicle-stimulating hormone
Controlled ovarian stimulation in IVF and clomifene-resistant PCOS.
SC
First-line for
- IVF ovarian stimulation
- Anovulation resistant to clomifene/letrozole
Mechanism
Direct FSH receptor agonism → multi-follicular recruitment.
"FSH → follicles → OHSS risk"
- Daily SC injection
- USS + oestradiol monitoring
- Trigger with hCG or GnRH agonist
Dosing
- Start
- 75–150 IU SC daily — individualised by AMH/AFC
Contraindications
- AbsolutePregnancy, ovarian cysts (non-PCOS), hormone-dependent tumours, undiagnosed bleeding
Side effects
- OHSS — mild to life-threatening
- Multiple pregnancy
- Injection-site reactions
- Thromboembolism (with severe OHSS)
Fetal & maternal notes
- • Not used once pregnancy achieved
Key interactions
GnRH analogues
OKStandard co-treatment in IVF protocols
Clomifene
AvoidAdditive OHSS risk — avoid combined
Clinical pearls
- 💡 Use GnRH-agonist trigger in high-responders to reduce OHSS
- 💡 Freeze-all strategy if OHSS threatens
Content last reviewed: REPLACE_ME (e.g. 2026-07)
Spotted something out of date? See our disclaimer or use Report an Error above.