One common treatment for infertility is to stimulate ovulation. To obtain several eggs suitable for fertilization, it is necessary to conduct a special drug therapy. Gonal-F is considered one of the most effective drugs in this area. The Gonala-F instruction strongly recommends that treatment be carried out under the strict supervision of a physician.
Product Description
Everyone knows that pregnancy cannot occur without ovulation. Therefore, many representatives of the fair sex, faced with such a difficult problem, decide on stimulation and in vitro fertilization. The attending physician must first conduct a medical examination, select the appropriate procedure for the procedure and suitable drugs.
The safest and most effective are funds based on follicle-stimulating hormone - FSH (recombinant), which is responsible for the maturation of follicles in the body of a woman. The instruction "Gonala-F" reports that the drug belongs to this category and, according to the mechanism of action, is as close as possible to natural FSH. You can buy a medication only by prescription.
Indications for use
The drug is in demand in the gynecological field and is prescribed if it is necessary to activate the growth of follicles. Indications for appointment "Gonal-F" has the following:
- Lack of ovulation and unsatisfactory result after the use of “Clomiphene”.
- Polycystic ovary syndrome (pathology associated with hormonal disorders that cause malfunctions of the ovaries).
- The need to stimulate multiple follicles for IVF.
Numerous medical studies have confirmed the effectiveness of the drug if it is necessary to develop several follicles during ovarian hyperstimulation (controlled). It has been established that the active component contributes to the growth of follicles and at the same time significantly reduces the risk of ovarian hyperstimulation.
Application for men
If the basic functions of the male sex glands are not fulfilled, the process of spermatogenesis - the formation and development of spermatozoa - is violated. Follicle-stimulating hormone is necessary to “start” this process, the duration of which is 75 days. A pathological condition can be detected only after passing a medical diagnosis and passing a spermogram.
Stimulation (or restoration) of the normal formation of male sex gametes sometimes takes a longer time than a similar procedure in women. For a positive treatment result, the recommendations of the andrologist should be fully observed. It is necessary to adhere to a specially designed diet, to abandon the use of alcohol and nicotine. Mandatory prescribe special drugs. The Gonala-F instruction says that the medication can be used to improve spermatogenesis in men who have acquired or congenital hypogonadism. Therapy should be carried out under the constant supervision of a specialist with experience in the treatment of infertility.
The composition of the drug
The active component of the drug is follitropin alpha - a substance that stimulates the growth of follicles in women with disorders in the hypothalamic-pituitary system. The bioavailability of the drug with subcutaneous administration is approximately 70%.
The active component begins to accumulate in the body after repeated administration. During the first 3 days, a three-fold increase in the equilibrium concentration of follitropin alpha is observed, which triggers the stimulation process.
Auxiliary components contained in the drug: sodium hydroxide and hydrogen phosphate dihydrate, phosphoric acid, methionine, sucrose, polysorbate 20.
Release form
Gonal F is manufactured by the Italian pharmaceutical company Industry Pharmaceuticals Serono S.p.A. The form of release of the drug is a solution for subcutaneous administration and a lyophilisate for the preparation of a liquid.
Pen-shaped syringes may contain 0.5, 0.75 and 1.5 ml of solution. The lowest dosage corresponds to 22 micrograms of follitropine alpha (300 IU), the average - 33 mg of the active component (450 IU). The largest amount of active substance is contained in 1.5 ml of solution - 66 micrograms (Gonal-F 900). The price of the drug depends on the concentration of the active substance.
The syringe pen has a special dispenser and a scale that allows you to control the dose of the drug. In this form, buying a medicine is most beneficial due to various dosages. The advantages include the lack of the need to prepare a solution before each injection.
The lyophilisate for solution preparation is diluted with injection liquid before each manipulation. The required dosage is previously calculated by a specialist for each individual case.
How is Gonalom-F treated?
In the absence of ovulation, therapy is started in the first week of the monthly cycle, subject to regular menstruation (some deviations in frequency are possible). The stimulation process must be carried out under the control of ultrasound , which allows you to control the size of the follicles. The initial dose is 0.13-0.25 ml of the drug "Gonal-F 75". The price of a solution containing 5.5 mg of follitropin alfa will be the lowest and is about 110 rubles. The dose is increased after 1-2 weeks to 225 IU (maximum).
If within a month the treatment does not give positive results, drug therapy should be canceled. For further treatment, the initial dose will be increased.
If necessary, a controlled ovarian hyperstimulation of the drug is prescribed in a dosage of 150-225 IU. The maximum daily dose should not exceed 450 IU. Therapy begins with 2-3 days of the menstrual cycle. Using ultrasound, a specialist will monitor the growth of follicles. The duration of treatment can be from 5 to 20 days. After the last injection of the solution, after 48 hours, an injection of chorionic gonadotropin is given.
Men who have problems with the spermatogenesis process are also shown stimulation. "Gonal-F" in this case is used in combination with chorionic gonadotropin. The usual treatment regimen is subcutaneous administration of the drug three times a week (dosage of 150 IU). The duration of therapy should be at least 4 months, after which the man needs to undergo an examination. With a slight improvement or lack of results, treatment can be extended to 18 months.
Mode of application
The first injection of the drug should be carried out by a specialist in stationary conditions. After being instructed, in the future the patient will be able to independently use a pen-syringe and make an injection of Gonal-F. You should first familiarize yourself with the instructions for the drug.
The following recommendations are for self-administration of the drug:
- Before stabbing Gonal-F, you should thoroughly wash your hands with soap and, if possible, additionally treat with an antiseptic.
- Fill the necessary items on a clean surface: a syringe pen, a bottle of powder and water for injection, alcohol, cotton swabs.
- It is necessary to prepare a syringe pen, remove the caps, set the desired dosage and attach the needle.
- The lyophilisate (powder) is diluted with water for injection by introducing the liquid into a dry substance vial. The rubber cap should be pierced with a needle; there is no need to open the bottle. The liquid should be administered slowly.
- It is necessary to draw air into the syringe to the required dose, insert the needle into the vial with the solution (first turn it upside down), introduce air and draw the right amount of medicine.
- There should be no air bubbles in the syringe. In order to get rid of them, you need to lightly tap your finger on the walls of the syringe, and the bubbles will move to the top. Then it is necessary to press on the piston and let out excess air.
- The skin at the injection site should be treated with an antiseptic (alcohol).
- The injection is done subcutaneously at an angle of 45 or 90 degrees. It is not necessary to press the syringe plunger sharply. The medicine should be administered slowly.
- To administer the drug “Gonal-F” with a syringe pen, just press the start button. The needle in this device is thin and small, so painful sensations are weakly expressed or practically absent.
- After the injection, a cotton swab dipped in an antiseptic should be applied to the injection site.
- Disposable syringe after the procedure is discarded.
- The needle from the syringe pen must be removed, put on the protective cap. For the next manipulation, you need to use a new needle, which comes complete with the drug.
Side effects
The drug "Gonal-F" can cause side effects in the treatment process. Some women have noted the following symptoms:
- From the reproductive system - ovarian cysts quite often developed.
- The negative effect of the drug can affect the digestive tract. This is expressed in the appearance of attacks of nausea, vomiting, diarrhea, discomfort and pain in the abdomen.
- Swelling or redness of the skin may form at the injection site.
- Cases of an allergic reaction were rather rare: urticaria, itching, shortness of breath, rash.
- From the central nervous system - headaches can become more frequent.
- Most rarely, there are cases of negative effects on the cardiovascular system (thromboembolism).
The instruction "Gonala-F" suggests that men may experience acne during therapy, and their body weight will increase slightly. There are rare cases of the development of varicocele, gynecomastia.
Contraindications
The drug has a serious effect on the body and therefore cannot be prescribed without prior treatment. The active substance and additional components have some limitations when used. The doctor should consider this and adjust the treatment regimen.
The instruction "Gonala-F" warns that the drug is forbidden to be used by persons with intolerance or hypersensitivity to substances in the composition. In this case, a severe allergic reaction and other complications may develop. Also contraindications include:
- Uterine bleeding of unknown etiology.
- Oncological pathology of the internal genital organs.
- Single ovarian cysts that did not develop on the background of polycystic.
- Pregnancy and lactation period.
- Congenital malformations of organs that are incompatible with pregnancy.
The specialist takes into account all concomitant diseases that are in the patient's history. In some situations, there is no need to use the Gonal-F tool. The price of treatment depends on the duration of therapy and the dosage of the medicine, but even expensive therapy will not bring the expected result with pathologies such as uterine fibroids, premature menopause, obstruction of the fallopian tubes.
Application features
Before prescribing a drug to stimulate ovulation or the spermatogenesis process, a doctor specializing in the treatment of infertility should conduct a medical diagnosis of the couple, which will help to eliminate the presence of contraindications and the need for treatment. The necessary scheme and dosage of the drug will also be established.
Patients who undergo Gonalom-F stimulation before IVF have a greater chance of becoming pregnant with twins. The doctor must inform the woman about this before starting treatment.
The simultaneous use of the drug with other agents that affect the growth of follicles can provoke the development of hyperstimulation. Throughout the course of therapy, it is necessary to conduct ultrasound diagnostics and control the growth of follicles.
Gonal-F: price and reviews
The Italian drug for stimulating ovulation has long been prescribed for the treatment of infertility in men and women. This is one of the most effective means (many doctors call it "heavy artillery"). Gonal-F showed positive results even in those cases when other well-known remedies were powerless. The basic rule that patients must observe is the complete medical monitoring of the process of follicular maturation and spermatogenesis.
During treatment, the dosage can be changed both to a smaller and a larger side. The cost of the drug ranges from 1100 rubles. up to 16 000 rub. ("Gonal-F" 900 IU). In addition to the use of an expensive product, it is mandatory to follow certain rules in the diet and completely eliminate junk food, processed foods.
During therapy, it is forbidden to drink alcohol, which has a negative effect on spermatogenesis, affecting the pituitary and hypothalamus, disrupting the metabolism of sex steroids. Hypersensitivity in sperm and nicotine.