In the article, we consider the drug "Puregon" and reviews on the results of IVF.
This medication is a follicle-stimulating recombinant hormonal drug. The composition of this medication includes follitropin beta, which is a hormone obtained through genetic engineering from the cells of the ovaries of a Chinese hamster, in which units of the gene for the human hormone that stimulate the formation of follicles are embedded.
The amino acid sequence of follitropine beta DNA is similar to that of natural human FGS. In this case, there are some differences in the structure of the carbohydrate chain.
The hormone that stimulates follicle formation in the body is necessary for the maturation and growth of follicles, as well as the proper synthesis of steroid hormones of the reproductive system. In the female body, the role of such a hormone is the main factor in the onset and duration of maturation in the ovaries of the follicles, as well as a regulator of their number and maturation period.
Description
The Puregon medicine is used to induce the maturation of follicles and steroid hormones in patients with ovarian dysfunction. In addition, this medicine is used to stimulate the multiple formation and development of follicles in cases of the need for artificial insemination (including in vitro fertilization (IVF) , embryo transplantation into the uterine cavity, intracytoplasmic sperm injection).
After a therapeutic course, this medication requires the introduction of human chorionic gonadotropin in order to induce the final stage of follicular maturation, rupture and continuation of meiosis.
Reviews about the "Puregon" are abundant.
Release form
The medication is produced in several pharmacological forms:
- Solutions for subcutaneous and intramuscular administration, which are a colorless transparent liquid (in glass bottles of 10 pieces in a cardboard box).
- Solutions for subcutaneous injection: colorless, transparent (in glass cartridges, one cartridge in a cardboard box, complete with special needles, in the amount of 6 or 9 pieces).
Structure
The composition of the drug in the form of a solution for intravenous administration includes an active element - follitropin beta recombinant, and additional components: polysorbate 20, sucrose, sodium citrate dihydrate, methionine, sodium hydroxide or hydrochloric acid, water for injection.
The composition of one cartridge includes the active element follitropin beta recombinant and auxiliary elements: polysorbate 20, sucrose, sodium citrate dihydrate, methionine, sodium hydroxide, benzyl alcohol, water for injection.
Reviews about Puregon and the results of IVF are most often positive.
pharmachologic effect
The composition of the drug contains follicle-stimulating recombinant hormone (FSH), obtained from cells of a Chinese hamster, which includes subunits of human FSH. For this reason, this medication is used to stimulate the production of estrogens and the formation of follicles in certain ovarian dysfunctions. In addition, the drug promotes the induction of multiple follicles during IVF and other modern reproduction techniques. This is confirmed by the instruction to the "Puregon." We will consider reviews below.
Pharmacodynamics
After intramuscular or subcutaneous administration of the drug, the maximum level of follicle-producing hormone in the blood is recorded after approximately 12 hours. In men (also used in male infertility), after intramuscular injection of a drug, the maximum level of the hormone in the plasma is achieved several times faster than in women.
Taking into account the gradual intake of follitropin beta recombinant in the body from the area of administration and a long half-life, which is usually 20–70 hours, the concentration of FSH remains high for 28–48 hours. Subsequently, repeated administration of the same dosage of the hormone causes a subsequent increase in the level of this hormone in the blood by 2 times compared with a single injection, which makes it possible to achieve the required concentration of FSH.
With subcutaneous and intramuscular administration of this drug, the pharmacokinetic parameters are almost the same. The bioavailability of the drug in this case is approximately 76%.
Recombinant FSH is similar in chemical parameters to FSH, which is found in human urine, and is identically metabolized, distributed and excreted.
It is better to familiarize yourself with the reviews of Puregon with IVF in advance.
Indications for appointment
The medication is prescribed for the treatment of female infertility with the following indications:
- induction of superovulation - to stimulate the multiple formation of follicles during the implementation of artificial insemination (for example, IVF, intrauterine insemination and ICSI);
- anovulation, including polycystic ovary syndrome in the absence of sensitivity to clomiphene.
Reviews of Puregon and the results of stimulation are presented at the end of the article.
Application restrictions
This drug has specific restrictions on use, which must be taken into account by specialists when prescribing. These include:
- anatomical violation of the genitals, excluding pregnancy;
- severe functional impairment of the liver or kidney;
- bleeding (vaginal or uterine) of unknown etiology;
- tumors in the uterus, mammary gland, ovary, hypothalamus, pituitary gland;
- cyst or ovarian enlargement due to polycystic disease;
- uterine fibroids, which in all respects is incompatible with pregnancy;
- cases of primary ovarian failure;
- decompensated pathologies of the endocrine system (for example, disorders in the thyroid gland, adrenal glands or pituitary gland);
- pregnancy, lactation;
- a high level of sensitivity to the elements present in the composition of the medicinal product.
Mode of application
The method of use and dosage of the drug should be established by a specialist who has practice in the treatment of infertility. The dosage is selected strictly individually, which is due to the response of the ovaries, under the supervision of estradiol concentrations and ultrasound studies.
Before IVF, Puregon stimulation, according to reviews, is usually well tolerated.
The medication acts at the lowest total dose and the same duration of treatment required for the formation of follicles. The success of therapy is most possible within 4 courses, in the future, this probability gradually decreases. With anovulation, it is recommended that a consistent treatment regimen be prescribed that begins with daily administration of a drug in a dosage of 50 ME for seven days. If there is no ovarian response, an increase in the daily dosage is shown until follicular development is reached and estradiol levels in the blood increase, which indicates the achievement of a pharmacodynamic response. After this, the daily dosage should be maintained until the state of preovulation, which is determined by the formation of a dominant follicle in diameter of at least 0.18 cm. There are also reviews of Puregon stimulation without IVF.
What is the duration?
Most often, to achieve the desired state, a therapeutic course of 2 weeks is necessary. After reaching the desired state, the administration of the drug “Puregon” should be stopped and ovulation induced by the administration of chorionic gonadotropin. If the level of estradiol rises too rapidly (within a few days more than 2 times) or the number of follicles is too large, the daily dosage should be reduced.
Since each follicle in diameter from 0.14 cm is considered preovulatory by specialists, the presence of such follicles increases the likelihood of multiple pregnancy. In this case, the hormone should not be administered. In addition, to prevent multiple pregnancy, it is recommended to take measures to protect against it with the help of barrier contraceptives. In order to induce superovulation during IVF, it is possible to use various methods of stimulating ovulation with a medication. During the first days, the introduction of 150-200 ME of the drug is recommended. Subsequently, the dose is set individually, in accordance with the reactions of the ovaries.
How to enter?
In order to prevent pain during the administration of the drug and to minimize its leakage, Puregon is recommended to be administered slowly. Due to the risk of fatty atrophy, the injection sites must be alternated. Unused solutions are destroyed. It is possible to inject the medicine subcutaneously on your own, since the solution in the cartridges is intended for administration under the skin with the help of a special injector pen. The abdomen near the navel is the best place for subcutaneous injections of the drug. It should be changed with each introduction - it is possible in other parts of the body. With the introduction of the drug, the needle is inserted under the skin at an angle of 90 °.
Side effects
According to reviews of Puregon, during the use of a medical product, it is possible to develop a variety of local adverse reactions in the form of hematomas, soreness, hyperemia, swelling, and itching. In most cases, such reactions are moderate and short-lived. In rare cases, systemic allergic manifestations were observed - erythema, rash, urticaria and itching. In addition, the following conditions were noted during treatment:
- syndrome of increased ovarian stimulation, which can be manifested by diarrhea, nausea, bloating and abdominal pain, ovarian enlargement, ascites, hydrothorax and weight gain, thromboembolism (arterial or venous);
- spontaneous abortion;
- severe soreness and hardening of the mammary glands;
- increased likelihood of multiple or ectopic pregnancy.
This is also confirmed by the instructions for use and reviews of Puregon.
Special recommendations
Before using the medicine, it is necessary to exclude endocrine pathologies, as well as to warn a woman about the possibility of a multiple pregnancy.
Initial administration of the drug must be carried out under the supervision of a specialist. With IVF, there is the likelihood of abortion at an early stage, as well as the formation of congenital malformations in the fetus. The risk of an ectopic pregnancy increases, especially in the presence of abnormalities in the development of the fallopian tubes.
Feedback on Puregon and the results of IVF can confirm this.
Before stimulation and during treatment, it is necessary to conduct ultrasound monitoring in order to monitor the development of follicles. It is also recommended to monitor the level of estradiol in the blood.
Women at risk for thrombosis have a high probability of venous or arterial thromboembolism, therefore, before using the Puregon medication, these patients should compare the probability of successful ovulation induction with the risk of complications.
Puregon may contain traces of streptomycin or neomycin, which may be the main reason for the development of increased susceptibility.
This medication cannot affect the ability to drive vehicles and other complex mechanisms.
Reviews about Puregon
Most women who have undergone an appropriate therapeutic course, in most cases leave positive feedback about this medication. This medicine has helped many patients who note that it is very well tolerated and convenient to use. Patients observed that the medication successfully activates the process of follicle formation during stimulation of the ovulatory process and significantly increases the likelihood of conception and pregnancy. The evidence that follicle stimulation was successfully performed in this category of women was proved by ultrasound studies.
Negative reviews of Puregon are rare, and complaints about the high price of the drug or some side symptoms when using it predominate among them. In general, patients are satisfied with the effectiveness of the drug, and many of them have a long-awaited pregnancy.
We reviewed reviews of Puregon stimulation.