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Burman's staff is dedicated to meeting
the needs of our infertility patients. We realize the
importance of fast and accurate service, as it is often
impossible for a patient to wait for medication. Unlike many
local pharmacies, we always have sufficient quantities
of FSH products available and guarantee delivery within
24 hours.
The active ingredient in all of the
above products is follicle stimulating hormone (FSH).
FSH is given by injection and stimulates
the ovaries directly to recruit and develop numerous follicles.
These drugs are used in stimulated intrauterine insemination
(IUI) and in assisted reproductive technologies (ART),
such as IVF, where many eggs are needed.
In general, there is a "dose related"
response to FSH, unlike Clomid. Multiple follicles
are usually recruited and the number, and their development,
increases as the dose of FSH increases. It is important
to closely monitor patients for serious side effects
such as ovarian hyperstimulation syndrome.
These products can be divided into two
main categories: 1. Those derived from human sources,
which include Repronex, Bravelle, and Menopur and
2. Those made using genetic recombinant mammalian
cell technology such as Gonal-F and Follistim. These products all produce ovarian
stimulation and opinions differ as to which type of
product is the most effective.
Pergonal was the first injectable ovulation
induction agent introduced into the United States and
is similar to Repronex. Pergonal was obtained from the
urine of post menopausal women who naturally have high
FSH levels since their ovaries are no longer functioning.
Pergonal was discontinued by Serono laboratories upon
the introduction of Metrodin (a purer product) and later
Gonal-F (pure FSH).
After purification significant amounts
of FSH (75 IU) and LH (75 IU) were found in Pergonal
and are present in Repronex. Many physicians believe
that the LH provides for a "better, shorter"
stimulation than the pure FSH products. This is one
reason for Repronex's popularity, coupled with it's lower
cost.
Bravelle, Menopur, and Repronex are
all "human derived" products. Menopur and
Repronex both contain comparable amounts of FSH and
LH whereas Bravelle is further purified to consist
of 75 IU of FSH and less than 2% LH.
Follistim and Gonal-F are pure products
derived from genetic recombinant mammalian cell technology.
Essentially, the mammalian cell is genetically programmed
to produce pure FSH identical to that found in the human.
There is much discussion among fertility specialists
as to whether or not the pure FSH products provide a
"better" ovarian stimulation.
All of these products are administered
according to protocols individually tailored to each
patient. Dosages are adjusted to provide optimal response
and prevent serious side effects. Patients must be
regularly monitored using ultrasound, to visualize
follicular development, and estrogen measurements.
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