Gonal-F (Follitropin Alfa)

Gonal‑F is indicated for several fertility‑related conditions where stimulation of follicular growth is required.

• Infertility caused by anovulation, such as in polycystic ovary syndrome.
• Controlled ovarian stimulation for assisted reproductive technology procedures, including in‑vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).
• Induction of follicular development in women with hypogonadotropic hypogonadism.
• Use in combination with other gonadotropins or luteinising hormone preparations as directed by a reproductive specialist.
• Support of oocyte maturation in donor egg cycles where controlled follicular response is essential.

The safety profile of Gonal‑F includes a range of observed adverse events, which are generally classified by frequency and severity.

Common

• Injection‑site reactions such as mild pain, redness, or swelling.
• Headache or mild dizziness.
• Nausea or abdominal discomfort.
• Ovarian hyperstimulation syndrome (OHSS) of mild to moderate intensity.
• Visual disturbances such as blurred vision.
• Mild fatigue or irritability.

Serious

• Severe OHSS requiring hospitalization.
• Ovarian cyst formation or torsion.
• Allergic reactions including rash, urticaria, or anaphylaxis.
• Thromboembolic events associated with severe OHSS.
• Significant ovarian enlargement leading to abdominal pain.
• Acute pelvic inflammatory complications.

When prescribing Gonal‑F, clinicians consider several precautionary measures to minimise risks and ensure appropriate patient selection.

• Evaluate baseline ovarian reserve and monitor follicular response throughout treatment.
• Avoid use in patients with known hypersensitivity to any component of the product.
• Use caution in individuals with a history of ovarian cysts, endometriosis, or severe OHSS.
• Discontinue therapy if signs of moderate or severe OHSS develop.
• Counsel patients on the importance of adhering to scheduled monitoring visits and ultrasound examinations.
• Consider the potential impact of pregnancy on dosing and continue only under specialist supervision.

Gonal‑F may interact with other medications or substances that affect ovarian response or hormone metabolism, requiring careful review of concomitant therapy.

Avoid

• Concurrent use of high‑dose estrogen‑containing oral contraceptives that may blunt the intended ovarian stimulation.
• Co‑administration with other gonadotropins at doses exceeding recommended limits, which can increase the risk of OHSS.

Use with caution

• Anticoagulants or antiplatelet agents, as severe OHSS may predispose to thromboembolic complications.
• Medications that alter pituitary function, such as dopamine agonists, which could affect endogenous FSH levels.
• Herbal supplements or over‑the‑counter products that contain phytoestrogens, potentially influencing follicular development.