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Fertility Issues Topics..

You are here : home > Fertility Issues > Female Infertility > Drug: Human Menopausal Gonadotrophins (H.M.G. or Pergonal)

Drug: Human Menopausal Gonadotrophins (H.M.G. or Pergonal)

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. 

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ghalib.8 years ago
show me prices
nimesis.8 years ago
i have gone through the site but i would like that some more details be included like ......
Frustrated.8 years ago
aparently pergonal is being discontinued... do you know why?
Monr2773.8 years ago
i recently tried the repronex and gonal-f and failed. does anyone know what the chances are that pergonal would work?
Pergonal.8 years ago
it looks to me that pergonal is the best i have my best friend who has been trying to get pregnant for seven long years and has tried clomid and failed, and she wants a baby more then anything in this world. would this fertility drug be recomended?
leona.8 years ago
i have a split cervix and 2 uterus,i have tried clomide and failed,supposed to be getting ivf but doctors haven't dealt with my condition. i will be getting a trial embryo transfer if that not successful ivf will be ruled out,they have mentioned pergonal,
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