In this articleWhat is amenorrhoeaWhat is PergonalWhat tests are required before taking PergonalHow is Pergonal administeredWhat do I need to do while on PergonalWhat are the possible side effects of PergonalHow effective is the Pergonal therapyDoes Pergonal result in multiple birthsWhat is amenorrhoea If your pituitary gland fails to produce F.S.H. and L.H. there will be no corresponding production of estrogen by the ovaries. Consequently, you will have amenorrhoea. A Progesterone Challenge Test will be negative in that it will not result in a withdrawal bleed. The only way in which you are likely to be able to become pregnant is to by-pass the pituitary by taking F.S.H. and L.H. injections directly. What is Pergonal Pergonal is a combination of human F.S.H. and L.H.. These hormones have been extracted from the urine of menopausal women and purified. Each ampoule of Pergonal contains 75 international units each of F.S.H. and L.H. What tests are required before taking Pergonal Pergonal is expensive and it has a greater potential for causing complications than have other ovulation inducing drugs. Before the commencement of this therapy it is essential to determine that amenorrhea is not linked to other causes like hyperprolactinaemia or ovarian failure. Your husbands semen will be analyzed to confirm that it is normal. It is also imperative to check that the tubes are patent. It will be an extremely unpleasant surprise to discover that your tubes are blocked or that your husband is sterile after you have spent a substantial amount on Pergonal therapy. As the treatment program is complex, doctors generally carry out a Pergonal counseling session with a couple, in order to ensure that they fully understand the intricacies of treatment and how to avoid the possible problems. How is Pergonal administered Pergonal is given in two main ways. It can be given by three equal alternate day injections or by a daily injection program in which the dosage is increased until a satisfactory response has been obtained. As long as the estrogen level is within the acceptable range, giving an injection of 10,000 units of H.C.G stimulates ovulation. You will not ovulate unless you are given the H.C.G. However, if the estrogen level was very high, the H.C.G. would be withheld. Ovulation would not occur and after a few days a period would commence and treatment could be restarted. Sometimes improved results can be obtained by adding clomiphene to Pergonal. Some clinics are fortunate in having the facility of ultrasound scanning of the ovaries before giving the H.C.G. In this way the number of follicles likely to ovulate can be seen and actually measured. Unfortunately, there is no definite relationship between the number of follicles that will ovulate and the estrogen levels reached. What do I need to do while on Pergonal The basis on which Pergonal therapy works is that if you are given F.S.H. (the important component of Pergonal) the ovary will respond with the production of estrogen. It will be necessary to monitor your estrogen levels by means of 24-hour urine collections. The aim of treatment is to try to produce an estrogen level in the range of 180-514 nMol, per 24-hour urine collection. Below 180 is usually too low for ovulation and above 514 the risk of multiple births is increased. What are the possible side effects of Pergonal If the H.C.G. injection is given when the estrogen level is very high, there is a risk of ovarian hyperstimulation. Mild hyperstimulation is in the region of 5% of all treatment cycles and is marked by abdominal distension and moderate pain due to ovarian enlargement. Severe hyperstimulation is fortunately very rare. It occurs in less than half of 1% of treatments, but can be dangerous. Ovarian hyperstimulation can only occur after the H.C.G. is given. In clinics without ultrasound, they rely heavily on the readings of the final estrogen level to determine whether or not to give the H.C.G. So the accuracy of the 24 hour urine collection is vital. How effective is the Pergonal therapy The success rate among this group of patients is good, with at least a 60% pregnancy rate. However, the miscarriage rate is higher than among clomiphene pregnancies, but this is probably related to the increased number of multiple pregnancies. There is no increase in the abnormality rate for Pergonal babies. Does Pergonal result in multiple births Close to 70% of the pregnancies result in a single baby, while 27% deliver twins. In other words, 97% of the pregnancies produce 1 or 2 babies only. That leaves 3% of the pregnancies that may result in 3 or more babies.
What is amenorrhoea
If your pituitary gland fails to produce F.S.H. and L.H. there will be no corresponding production of estrogen by the ovaries. Consequently, you will have amenorrhoea. A Progesterone Challenge Test will be negative in that it will not result in a withdrawal bleed. The only way in which you are likely to be able to become pregnant is to by-pass the pituitary by taking F.S.H. and L.H. injections directly.
What is Pergonal
Pergonal is a combination of human F.S.H. and L.H.. These hormones have been extracted from the urine of menopausal women and purified. Each ampoule of Pergonal contains 75 international units each of F.S.H. and L.H.
What tests are required before taking Pergonal
Pergonal is expensive and it has a greater potential for causing complications than have other ovulation inducing drugs. Before the commencement of this therapy it is essential to determine that amenorrhea is not linked to other causes like hyperprolactinaemia or ovarian failure. Your husband's semen will be analyzed to confirm that it is normal. It is also imperative to check that the tubes are patent. It will be an extremely unpleasant surprise to discover that your tubes are blocked or that your husband is sterile after you have spent a substantial amount on Pergonal therapy. As the treatment program is complex, doctors generally carry out a Pergonal counseling session with a couple, in order to ensure that they fully understand the intricacies of treatment and how to avoid the possible problems.
How is Pergonal administered
Pergonal is given in two main ways. It can be given by three equal alternate day injections or by a daily injection program in which the dosage is increased until a satisfactory response has been obtained. As long as the estrogen level is within the acceptable range, giving an injection of 10,000 units of H.C.G stimulates ovulation. You will not ovulate unless you are given the H.C.G. However, if the estrogen level was very high, the H.C.G. would be withheld. Ovulation would not occur and after a few days a period would commence and treatment could be restarted. Sometimes improved results can be obtained by adding clomiphene to Pergonal.
Some clinics are fortunate in having the facility of ultrasound scanning of the ovaries before giving the H.C.G. In this way the number of follicles likely to ovulate can be seen and actually measured. Unfortunately, there is no definite relationship between the number of follicles that will ovulate and the estrogen levels reached.
What do I need to do while on Pergonal
The basis on which Pergonal therapy works is that if you are given F.S.H. (the important component of Pergonal) the ovary will respond with the production of estrogen. It will be necessary to monitor your estrogen levels by means of 24-hour urine collections. The aim of treatment is to try to produce an estrogen level in the range of 180-514 nMol, per 24-hour urine collection. Below 180 is usually too low for ovulation and above 514 the risk of multiple births is increased.
What are the possible side effects of Pergonal
If the H.C.G. injection is given when the estrogen level is very high, there is a risk of ovarian hyperstimulation. Mild hyperstimulation is in the region of 5% of all treatment cycles and is marked by abdominal distension and moderate pain due to ovarian enlargement. Severe hyperstimulation is fortunately very rare. It occurs in less than half of 1% of treatments, but can be dangerous. Ovarian hyperstimulation can only occur after the H.C.G. is given. In clinics without ultrasound, they rely heavily on the readings of the final estrogen level to determine whether or not to give the H.C.G. So the accuracy of the 24 hour urine collection is vital.
How effective is the Pergonal therapy
The success rate among this group of patients is good, with at least a 60% pregnancy rate. However, the miscarriage rate is higher than among clomiphene pregnancies, but this is probably related to the increased number of multiple pregnancies. There is no increase in the abnormality rate for Pergonal babies.
Does Pergonal result in multiple births
Close to 70% of the pregnancies result in a single baby, while 27% deliver twins. In other words, 97% of the pregnancies produce 1 or 2 babies only. That leaves 3% of the pregnancies that may result in 3 or more babies.
